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Do Mean Values of the Peak Inspiratory Nasal Flowmeter Vary According to the Severity, Direction and Type of Nasal Septum Deviation?

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Abstract

The aim is to investigate the contribution of the PNIF test in daily clinical practices in the objective evaluation of the early postoperative functional results of septoplasty and the effect of the severity, direction, and type of nasal septum deviation on mean PNIF values. Nasal septum deviation (NSDs) of the cases were grouped according to the Mladina classification and the severity of NSDs. An objective evaluation of the nasal airway was conducted via a peak flowmeter device in the preoperative and postoperative first month. When examining the mean PNIF values according to genders, it was observed that the values determined in male cases in the preoperative and postoperative period were higher. In the intragroup evaluation performed according the Mladina classification, a statistically significant increase was observed in the preoperative and postoperative PNIF values of the cases in Types 1–4. In the intragroup evaluation performed according to the severity of NSD, there was a significant increase in the preoperative and postoperative PNIF values of the mild and moderate cases. When comparing the preoperative and postoperative PNIF values of the groups in terms of the severity of NSD, it was observed that there was a significant difference. The PNIF can be used in routine clinical practices to evaluate the septoplasty results objectively. In the evaluation of functional results, the change in the mean PNIF values may also vary according to the direction and severity of septum deviation and the Mladina classification other than age, gender and ethnic origin.

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References

  1. Vainio-Mattila J (1974) Correlations of nasal symptoms and signs in random sampling study. Acta Otolaryngol Suppl 318:1–48

    Article  CAS  PubMed  Google Scholar 

  2. Dinis PB, Haider H (2002) Septoplasty long term evaluation of results. Am J Otolaryngol 23:85–90

    Article  PubMed  Google Scholar 

  3. Panagou P, Loukides S, Tsipra S et al (1998) Evaluation of nasal patency: comparison of patient and clinician assessments with rhinomanometry. Acta Otolaryngol 118:847–851

    Article  CAS  PubMed  Google Scholar 

  4. Aaronson NL, Vining EM (2014) Correction of the deviated septum: from ancient Egypt to the endoscopic era. Int Forum Allergy Rhinol 4(11):931–936

    Article  PubMed  Google Scholar 

  5. Rhee JS, McMullin BT (2008) Outcome measures in facial plastic surgery: patient-reported and clinical efficacy measures. Arch Facial Plast Surg 10(3):194–207

    Article  PubMed  Google Scholar 

  6. Tsang CLN, Nguyen T, Sivesind T, Cervin A (2018) Long-term patient-related outcome measures of septoplasty: a systematic review. Eur Arch Otorhinolaryngol 275(5):1039–1048. https://doi.org/10.1007/s00405-018-4874-y (Epub 2018 Jan 13)

    Article  PubMed  Google Scholar 

  7. Andrews PJ, Choudhury N, Takhar A, Poirrier AL, Jacques T, Randhawa PS (2015) The need for an objective measure in septorhinoplasty surgery: are we any closer to finding an answer? Clin Otolaryngol 40(6):698–703. https://doi.org/10.1111/coa.12455

    Article  CAS  PubMed  Google Scholar 

  8. Stewart MG, Smith TL, Weaver EM et al (2004) Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 130(3):283–290

    Article  PubMed  Google Scholar 

  9. Moore M, Eccles R (2011) Objective evidence for the efficacy of surgical management of the deviated septum as a treatment for chronic nasal obstruction: a systematic review. Clin Otolaryngol 36(2):106–113. https://doi.org/10.1111/j.1749-4486.2011.02279.x

    Article  CAS  PubMed  Google Scholar 

  10. Clement PAR (1984) Committee report on standardization of rhinomanometry.Rhinology 22: 151–67

  11. Gymer LF (1995) Reduction rhinoplasty and nasal patency: change in the cross sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 105:429–455

    Article  Google Scholar 

  12. Lodder WL, Leong SC (2018) What are the clinically important outcome measures in the surgical management of nasal obstruction? Clin Otolaryngol 43(2):567–571. https://doi.org/10.1111/coa.13023 (Epub 2017 Nov 23)

    Article  PubMed  Google Scholar 

  13. Starling-Schwanz R, Peake HL, Salome CM et al (2005) Repeatability of peak nasal inspiratory flow measurements and utility for assessing the severity of rhinitis. Allergy 60:795–800

    Article  CAS  PubMed  Google Scholar 

  14. Timperley D, Srubisky A, Stow N, Marcells GN, Harvey RJ (2011) Minimal clinically important differences in nasal peak inspiratory flow. Rhinology 49(1):37–40. https://doi.org/10.4193/Rhino10.097

    Article  PubMed  Google Scholar 

  15. Ottaviano G, Fokkens WJ (2016) Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in Daily practice. Allergy 71(2):162–174. https://doi.org/10.1111/all.12778

    Article  CAS  PubMed  Google Scholar 

  16. Mladina R (1987) The role of maxillary morphology in the development of pathological septal deformities. Rhinology 25:199–205

    CAS  PubMed  Google Scholar 

  17. Verhoeven S, Schmelzer B (2016) Type and severity of septal deviation are not related with the degree of subjective nasal obstruction. Rhinology 54:355–360

    Article  CAS  PubMed  Google Scholar 

  18. Rhee JS, Arganbright JM, McMullin BT, Hannley M (2008) Evidence supporting functional rhinoplasty or nasal valve repair: a 25 yar systematic review. Otolaryngol Head Neck Sur 139:10–20

    Article  Google Scholar 

  19. Paul MA, Kamali P, Chen AD, Ibrahim AMS, Wu W, Becherer BE, Medin C, Lin SJ (2018) Assessment of Functional Rhinoplasty with Spreader Grafting Using Acoustic Rhinomanometry and Validated Outcome Measurements. Plast Reconstr Surg Glob Open 6(3):e1615. https://doi.org/10.1097/GOX.0000000000001615

    Article  PubMed  PubMed Central  Google Scholar 

  20. Valsamidis K, Titelis K, Rachovitsas D, Konstantinidis I, Markou K, Triaridis S (2018) Long-term evaluation of nasal septoplasty followed by inferior turbinate cauterization for the treatment of nasal obstruction using objective and subjective methods. Int Arch Otorhinolaryngol 22(3):284–290. https://doi.org/10.1055/s-0037-1613688

    Article  PubMed  PubMed Central  Google Scholar 

  21. Youlten LJ (1980) The peak nasal inspiratory flow meter: a new instrument for the assessment of the response to immunotherapy in seasonal allergic rhinitis. Allergol immunopathol 8:344

    Google Scholar 

  22. Bermüller C, Kirsche H, Rettinger G, Riechelmann H (2008) Diagnostic accuracy of peak nasal inspiratory flow and rhinomanometry in functional rhinosurgery. Laryngoscope 118:605–610

    Article  PubMed  Google Scholar 

  23. Wilson AM, Sims EJ, Robb F, Cockburn W, Lipworth BJ (2003) Peak inspiratory flow rate is more sensitive than acoustic rhinometry or rhinomanometry in detecting corticosteroid response with nasal histamine chal- lenge. Rhinology 41:16–20

    PubMed  Google Scholar 

  24. Ozturan O, Gürdal MM (20010) Nazal tikanikliğin değerlendirilmesinde tepe nazal inspiratuvar akimmetre [Peak nasal inspiratory flowmeter in evaluation of nasal obstruction]. Kulak Burun Bogaz Ihtis Derg 20(3): 154–60. Turkish

  25. Ozkul HM, Balikci HH, Gurdal MM, Celebi S, Yasar H, Karakas M, Alp A (2013) Normal range of peak nasal inspiratory flow and its role in nasal septal surgery. J Craniofac Surg 24(3):900–902. https://doi.org/10.1097/SCS.0b013e318280263a

    Article  PubMed  Google Scholar 

  26. Ottaviano G, Scadding GK, Coles S et al (2006) Peak nasal inspiratory flow; normal range in adult population. Rhinology 44:32–35

    PubMed  Google Scholar 

  27. Blomgren K, Simola M, Hytonen M et al (2003) Peak nasal inspiratory and expiratory flow measurements—practical tools in primary care? Rhinology 41:206–210

    PubMed  Google Scholar 

  28. Klossek JM, Lebreton JP, Delagranda A, Dufour X (2009) PNIF measurement in a healthy French population. A prospective study about 234 patients. Rhinology 47(4): 389–92. doi: https://doi.org/10.4193/Rhin08.083.

  29. Larsen K, Oxhøj H, Grøntved A, Kristensen S (1990) Peak flow nasal patency indices in patients operated for nasal obstruction. Eur Arch Otorhinolaryngol 248:21–24

    Article  CAS  PubMed  Google Scholar 

  30. Low WK (1994) Can snoring relief after nasal septal surgery be predicted? Clin Otolaryngol 19:142–144

    Article  CAS  PubMed  Google Scholar 

  31. Balikci HH, Gurdal MM (2014) Use of peak nasal inspiratory flowmetry and nasal decongestant to evaluate outcome of septoplasty with radiofrequency coblation of the inferior turbinate. Rhinology 52(2):112–115. https://doi.org/10.4193/Rhin13.181

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Selim Çam for his contribution to statistical evaluation.

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Authors and Affiliations

  1. Department of Otolaryngology, Faculty of Medicine, Sivas Cumhuriyet University, 58140, Sivas, Turkey

    Adem Bora, Yasin Aslan, Kasım Durmuş, Berat Baturay Demirkıran & Emine Elif Altuntas

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  1. Adem Bora
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  2. Yasin Aslan
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  3. Kasım Durmuş
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  4. Berat Baturay Demirkıran
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  5. Emine Elif Altuntas
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Contributions

Concept—EEA, AB, KD; Design—EEA, KD, AB; Supervision—EEA, AB, KD; Resource—EEA; Materials—AB, BBD, YS; Data Collection and/or Processing—AB, KDBBD, YS; Analysis and/or Interpretation—EEA, AB; Literature Search—KD, ABBBD, YS; Writing—EEA, AB; Critical Reviews—EEA, KD, AB.

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Correspondence to Adem Bora.

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The authors have no conflicts of interest to declare.

Ethical Approval

Ethics approval of this study was obtained from Cumhuriyet University Clinical Trials Ethics Committee (dated 09.10.2019 with decision no. ve 2019–10/06).

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Written informed consent was obtained from the patients who participated in this study.

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Bora, A., Aslan, Y., Durmuş, K. et al. Do Mean Values of the Peak Inspiratory Nasal Flowmeter Vary According to the Severity, Direction and Type of Nasal Septum Deviation?. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 1675–1682 (2022). https://doi.org/10.1007/s12070-021-02809-0

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  • DOI: https://doi.org/10.1007/s12070-021-02809-0

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