Evaluation of nasal obstruction in nasal septum deviations using objective and subjective methods: Evaluation of nasal obstruction in nasal septum deviations

Meltem Akpinar; Ozlem Saatci; Metin Celik

doi:10.28982/josam.8158

Authors

Meltem Akpinar University of Health Sciences, Sancaktepe Sehit Prof. Dr. Ilhan Varank Hospital, ENT Clinic, Istanbul, Turkey https://orcid.org/0000-0001-5281-1903
Ozlem Saatci University of Health Sciences, Sancaktepe Sehit Prof. Dr. Ilhan Varank Hospital, ENT Clinic, Istanbul, Turkey https://orcid.org/0000-0002-3372-9514
Metin Celik University of Health Sciences, Sancaktepe Sehit Prof. Dr. Ilhan Varank Hospital, ENT Clinic, Istanbul, Turkey https://orcid.org/0009-0004-7410-2322

DOI:

https://doi.org/10.28982/josam.8158

Keywords:

nasal, septum, deviation, inspiratory, flow

Abstract

Background/Aim: Nasal septum deviation (NSD) is a prevalent cause of nasal obstruction, significantly impairing quality of life. Although various subjective and objective assessment tools exist, the correlation between these methods remains insufficiently investigated. This study aimed to evaluate the relationship between septal deviation morphology and peak nasal inspiratory flow (PNIF) measurements, and to determine the correlation between objective PNIF values and subjective Nasal Obstruction Symptom Evaluation (NOSE) scores.

Methods: Between July and September 2023, 52 patients diagnosed with NSD and nasal obstruction, along with 20 healthy controls, were enrolled. Patients were classified into three groups (A, B, and C) based on the degree of nasal obstruction. PNIF measurements and NOSE scores were obtained from all participants.

Results: The mean NOSE score and PNIF value in the study group were 59.33 (27.19) and 76.73 (38.76) l/min, respectively, while the mean PNIF value in the control group was 145.5 (17.01) l/min. Statistically significant differences were found in PNIF and NOSE scores between groups. A strong correlation was observed between PNIF and NOSE scores (P=0.004).

Conclusion: The combined use of objective PNIF measurements and subjective NOSE assessments offers a comprehensive evaluation of nasal obstruction due to septal deviation, improving diagnostic accuracy and clinical decision-making.

Downloads

Download data is not yet available.

References

Özcan M. Anatomy and Physiology of the Nose. In: Koç C, ed. Diseases of the Ear, Nose, Throat, and Head and Neck Surgery. 3rd ed. Ankara: Güneş Tıp Kitabevleri; 2019:459-64.

Valero A, Navarro AM, Del Cuvillo A, et al. Position paper on nasal obstruction: evaluation and treatment. J Investig Allergol Clin Immunol. 2018;28:67-90.

Marro M, Mondina M, Stoll D, de Gabory L. French validation of the NOSE and RhinoQOL questionnaires in the management of nasal obstruction. Otolaryngol Head Neck Surg. 2011;144:988-93.

Mozzanica F, Urbani E, Atac M, et al. Reliability and validity of the Italian nose obstruction symptom evaluation (I-NOSE) scale. Eur Arch Otorhinolaryngol. 2013;270:3087-94.

Oktay MF, Ege SS. Nasal obstructions. Clin Dev. 2012;25:37-9.

Ottaviano G, et al. Peak Nasal Inspiratory Flow and Peak Expiratory Flow. Allergy. 2006;61(4):537-41.

Salihoglu M, Cekin E, Altundag A, Cesmeci E. Examination versus subjective nasal obstruction in the evaluation of the nasal septal deviation. Rhinology. 52nd ed. Istanbul: Otolaryngology Department of GATA Haydarpasa Training Hospital, Istanbul Surgery Hospital; 2014:122-6. doi: 10.4193/Rhino13.057.

Stewart MG, Witsell DL, Smith TL, et al. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngol Head Neck Surg. 2004;130(2):157-63.

Onerci Celebi O, Araz Server E, Yigit O, Longur ES. Adaptation and validation of the Turkish version of the Nasal Obstruction Symptom Evaluation scale. Int Forum Allergy Rhinol. 2018;8(1):72-6.

Ottaviano G, Fokkens WJ. Measurements of nasal airflow and patency: A critical review with emphasis on the use of peak nasal inspiratory flow in daily practice. Allergy. 2016;71(2):162-74.

Comparison of rhinometric measurements methods in intranasal pathology. 2003;41(2):65-8.

Cuddihy PJ, Eccles R. The use of nasal spirometry as an objective measure of nasal septal deviation and the effectiveness of septal surgery. Clin Otolaryngol Allied Sci. 2003;28(4):325-30.

Xavier R, Azeredo-Lopes S, Menger DJ, de Carvalho HC, Spratley J. Objective measurement and patient-reported evaluation of the nasal airway: Is correlation dependent on symptoms or on nasal airflow? Clin Otolaryngol. 2021 Jul;46(4):744-51. doi: 10.1111/coa.13726.

Yepes-Nuñez JJ, Bartra J, Muñoz-Cano R, et al. Assessment of nasal obstruction: correlation between subjective and objective techniques. Allergol Immunopathol (Madr). 2013;41(6):397-401.