Nasal valve elastography: quantitative determination of the mobility of the nasal valve

Background: The nasal valve area is the narrowest region of the entire upper airway. Numerous procedures and spreader devices are published to widen the nasal valve or to stabilize it, but the indications are based only on the surgeon’s experience. Methods: In 30 healthy volunteers the deflection of elastic steel elements touching the lower nasal side at its deepest point was precisely measured by means of strain gauges. The deflection was calibrated by standard calibration devices. A special 4-phaserhinomanometer (4RHINO/ Rhinolab/Germany) with a protective face mask allowed simultaneous measurements of the airflow and differential pressure. All signals were recorded simultaneously on both sides. The measurements have been carried out as unilateral measurements according to anterior rhinomanometry. Results: Surprisingly the lateral nasal wall is already moving during quiet breathing. The airflow and its acceleration as well as the pressure difference generating a complete closure of the nose can be determined and has expectedly a high variance between individuals. Conclusions: The elastography confirms the loops in 4-phase-rhinomanometry as symptomatic for the nasal valve elongation and will after developing as medical product allow the systematic quantitative measurement of the influence of the nasal valve on the nasal air stream.