Exploring the Relationships Between Clinical Examination Findings, Subjective Reported Symptoms and Objective Nasal Patency Measures in Nasal Obstruction: A Baseline NAIROS Sub-Study Analysis

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-09-08 DOI:10.1111/coa.14221

Pavithran Maniam, Alison Bray, Michael Drinnan, Tony Fouweather, M. Dawn Teare, Sean Carrie, James O'Hara

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Abstract

Background

The role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined.

Objective

To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction.

Methods

This is a sub-study of the NAIROS trial. Participants with nasal obstruction secondary to septal deviation were included in this NAIROS sub-study. The side of septal deviation, enlargement of inferior turbinate (IT), the need for IT reduction if septoplasty was being performed, the area of septum deflecting into the airway and observer rated airway block (ORAB–arbitrarily divided by <50% and >50% blockage) were assessed by clinicians. The subjective score of nasal obstruction was assessed using the Double Ordinal Assessed Subjective Scale (DOASS). Objective nasal patency measures (e.g., nasal partitioning ratio, [NPR] and PNIF) were measured using PNIF and rhinospirometry.

Results

The mean NPR for left-sided, both-sided and right-sided septal deviation was −0.35, −0.02 and 0.51, respectively (p < 0.001). There was very weak correlation between the requirement for IT reduction and PNIF change (0.13, p < 0.01). There was no difference in mean PNIF (94 L/min vs. 93 L/min) and mean DOASS (0.33 vs. 0.38) for participants with ORAB rated <50% and >50%. The mean NPR for participants with ORAB >50% was higher than for those with ORAB <50% (0.51 vs. 0.41, p = 0.002). There was strong correlation between the DOASS and NPR (+0.737, p < 0.001). The mean DOASS score for right-sided, both-sided and left-sided septal deviation was 0.32, 0.05 and −0.29, respectively (p < 0.001).

Conclusion

This study identified strong relationships between the clinician rated side of septal deflection, the patient reported DOASS and the objective NPR measurements. NPR and the clinician rated degree of airway blockage were concordant.

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探索鼻塞患者临床检查结果、主观症状报告与客观鼻腔通畅度测量之间的关系：NAIROS 子研究基线分析。

背景：在为患者提供鼻中隔成形术时，使用鼻吸气流量峰值法（PNIF）和鼻气压测定法进行的客观鼻气流测量在支持临床检查结果方面的作用仍未确定：探讨鼻阻塞患者的临床检查结果、主观报告症状和客观鼻腔通畅度测量之间的基线关系：这是 NAIROS 试验的一项子研究。方法：这是 NAIROS 试验的一项子研究。NAIROS 子研究纳入了因鼻中隔偏曲导致鼻塞的参与者。临床医生对鼻中隔偏曲的一侧、下鼻甲（IT）的增大、如果正在进行鼻中隔成形术是否需要缩小下鼻甲、鼻中隔偏曲进入气道的面积以及观察者评定的气道阻塞（ORAB--任意除以 50%的阻塞）进行了评估。鼻腔阻塞的主观评分采用双标度主观量表（DOASS）进行评估。客观鼻腔通畅度量（如鼻腔分隔比[NPR]和 PNIF）采用 PNIF 和鼻呼吸测定法进行测量：结果：左侧、两侧和右侧鼻中隔偏曲的平均 NPR 分别为-0.35、-0.02 和 0.51（p 50%）。室间隔偏折率大于 50% 的参与者的平均 NPR 值高于室间隔偏折率小于 50% 的参与者：本研究确定了临床医生评定的室间隔偏曲侧、患者报告的 DOASS 和客观 NPR 测量值之间的密切关系。NPR 和临床医生评定的气道阻塞程度是一致的。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.