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Objective:The nasal swell body（NSB） consists of the nasal septal cartilage, nasal bone, and swollen soft tissue, all of which are visible during endoscopic and imaging examinations. Although the function of the NSB remains uncertain, there is evidence to suggest that it plays a vital role in regulating nasal airflow and filtering inhaled air. Based on anatomical and histological evidence, it is hypothesized that the NSB is indispensable in these processes. This study aims to investigate the impact of NSB on nasal aerodynamics and the deposition of allergen particles under physiological conditions. Methods:The three-dimensional （3D） nasal models were reconstructed from computed tomography （CT） scans of the paranasal sinus and nasal cavity in 30 healthy adult volunteers from Northwest China, providing basis for the construction of models without NSB following virtual NSB-removal surgery. To analyze the distribution of airflow in the nasal cavity, nasal resistance, heating and humidification efficiency, and pollen particle deposition rate at various anatomical sites, we employed the computed fluid dynamics（CFD） method for numerical simulation and quantitative analysis. In addition, we created fully transparent segmented nasal cavity models through 3D printing, which were used to conduct bionic experiments to measure nasal resistance and allergen particle deposition. Results:①The average width and length of the NSB in healthy adults in Northwest China were （12.85±1.74） mm and （28.30±1.92） mm, respectively. ②After NSB removal, there was no significant change in total nasal resistance, and cross-sectional airflow velocity remained essentially unaltered except for a decrease in topical airflow velocity in the NSB plane. ③There was no discernible difference in the nasal heating and humidification function following the removal of the NSB; ④After NSB removal, the deposition fraction（DF） of Artemisia pollen in the nasal septum decreased, and the DFs post-and pre-NSB removal were（22.79±6.61）% vs （30.70±12.27）%, respectively; the DF in the lower airway increased, and the DFs post-and pre-NSB removal were（24.12±6.59）% vs （17.00±5.57）%, respectively. Conclusion:This study is the first to explore the effects of NSB on nasal airflow, heating and humidification, and allergen particle deposition in a healthy population. After NSB removal from the healthy nasal cavities: ①nasal airflow distribution was mildly altered while nasal resistance showed no significantly changed; ②nasal heating and humidification were not significantly changed; ③the nasal septum's ability to filter out Artemisia pollen was diminished, which could lead to increased deposition of Artemisia pollen in the lower airway.
Subject(s)
Adult , Humans , Cross-Sectional Studies , Nasal Cavity/surgery , Allergens , Pollen , Artemisia , HydrodynamicsABSTRACT
Objective:To analyze the correlation between nasal resistance and lung function in children with allergic rhinitis（AR）, and explore whether AR children with increased nasal resistance are accompanied by potential lower respiratory tract involvement. Methods:A total of 88 children diagnosed with AR from December 2021 to December 2022 were selected as the study group, while 20 normal children were selected as the control group during the same period. Both the study group and the control group children underwent lung function tests, bronchodilator tests, and nasal resistance measurements. Spearman correlation analysis and multiple linear regression analysis were performed on the results of nasal resistance and lung function tests to explore the relationship and influencing factors between the two groups.According to the results of nasal resistance measurement, children with increased nasal resistance and abnormal lung function were divided into a mild increase in nasal resistance with abnormal lung function group and a moderate to severe increase in nasal resistance with abnormal lung function group. The degree of increased nasal resistance was analyzed to determine whether it would affect lung function. Results:The FEF25, FEF50, and FEF75 levels in the study group were significantly lower than those in the control group（P<0.05）. The FEV1of children with moderate to severe increase in AR nasal resistance was significantly lower than that of children with mild increase in AR nasal resistance（P<0.05）. There was a correlation between nasal resistance and FEV1/FVC, R20 in AR children, and FEV1/FVC, R20 were the influencing factors of nasal resistance in AR children（P<0.05）. There was no correlation between total serum IgE, lung function, and bronchodilation test in AR patients（P>0.05）. Conclusion:The nasal ventilation function of AR patients has changed, and there is a downward trend in small airway function. Children with moderate to severe increase in AR nasal resistance have a more significant decrease in lung ventilation function than those with mild increase. The nasal resistance of AR children is influenced by FEV1/FVC and R20, and FEV1/FVC and R20 decrease as the nasal resistance value increases. The improvement rate of lung function and FEV1 are not influencing factors for the elevation of total serum IgE.
Subject(s)
Humans , Child , Rhinitis, Allergic/diagnosis , Nasal Polyps , Respiratory Function Tests , Nose , Immunoglobulin EABSTRACT
Nasal obstruction is a common symptom seen across various nasal pathologies, the objective way of measuring nasal obstruction is active rhinomanometry. To measure the difference in the nasal air?ow of cases of nasal pathology with nasal obstruction, a prospective study was undertaken to compare the pre and post-operative rhinomanometry ?ndings in cases presenting with nasal obstruction
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Abstract Introduction To provide clinical information and diagnosis in mouth breathers with transverse maxillary deficiency with posterior crossbite, numerous exams can be performed; however, the correlation among these exams remains unclear. Objective To evaluate the correlation between acoustic rhinometry, computed rhinomanometry, and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency. Methods A cross-sectional study was conducted in 30 mouth breathers with transverse maxillary deficiency (7-13 y.o.) patients with posterior crossbite. The examinations assessed: (i) acoustic rhinometry: nasal volumes (0-5 cm and 2-5 cm) and minimum cross-sectional areas 1 and 2 of nasal cavity; (ii) computed rhinomanometry: flow and average inspiratory and expiratory resistance; (iii) cone-beam computed tomography: coronal section on the head of inferior turbinate (Widths 1 and 2), middle turbinate (Widths 3 and 4) and maxilla levels (Width 5). Acoustic rhinometry and computed rhinomanometry were evaluated before and after administration of vasoconstrictor. Results were compared by Spearman's correlation and Mann-Whitney tests (α = 0.05). Results Positive correlations were observed between: (i) flow evaluated before administration of vasoconstrictor and Width 4 (Rho = 0.380) and Width 5 (Rho = 0.371); (ii) Width 2 and minimum cross-sectional areas 1 evaluated before administration of vasoconstrictor (Rho = 0.380); (iii) flow evaluated before administration of vasoconstrictor and nasal volumes of 0-5 cm (Rho = 0.421), nasal volumes of 2-5 cm (Rho = 0.393) and minimum cross-sectional areas 1 (Rho = 0.375); (iv) Width 4 and nasal volumes of 0-5 cm evaluated before administration of vasoconstrictor (Rho = 0.376), nasal volumes of 2-5 cm evaluated before administration of vasoconstrictor (Rho = 0.376), minimum cross-sectional areas 1 evaluated before administration of vasoconstrictor (Rho = 0.410) and minimum cross-sectional areas 1 after administration of vasoconstrictor (Rho = 0.426); (v) Width 5 and Width 1 (Rho = 0.542), Width 2 (Rho = 0.411), and Width 4 (Rho = 0.429). Negative correlations were observed between: (i) Width 4 and average inspiratory resistance (Rho = −0.385); (ii) average inspiratory resistance evaluated before administration of vasoconstrictor and nasal volumes of 0-5 cm (Rho = −0.382), and average expiratory resistance evaluated before administration of vasoconstrictor and minimum cross-sectional areas 1 (Rho = −0.362). Conclusion There were correlations between acoustic rhinometry, computed rhinomanometry, and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency.
Resumo Introdução Numerosos exames podem ser realizados para fornecer informações clínicas e diagnósticas em respiradores bucais com atresia maxilar e mordida cruzada posterior, entretanto a correlação entre esses exames ainda é incerta. Objetivo Avaliar a correlação entre rinometria acústica, rinomanometria computadorizada e tomografia computadorizada por feixe cônico em respiradores bucais com atresia maxilar. Método Um estudo de corte transversal foi realizado em 30 respiradores bucais com atresia maxilar (7-13 anos) com mordida cruzada posterior. Os exames avaliados foram: (i) rinomanometria acústica: volumes nasais (0-5 cm e 2-5 cm) e áreas mínimas de corte transversal 1 e 2 da cavidade nasal; (ii) rinomanometria computadorizada: fluxo nasal e resistências médias inspiratórias e expiratórias; (iii) tomografia computadorizada por feixe cônico: corte coronal na cabeça da concha inferior (larguras 1 e 2), concha média (larguras 3 e 4) e na maxila (Largura 5). Rinomanometria acústica e rinomanometria computadorizada foram avaliadas antes e depois da administração de vasoconstritor. Os resultados foram comparados pelo teste de correlação de Spearman e pelo teste de Mann-Whitney (α = 0,05). Resultados Foram encontradas correlações positivas entre: (i) fluxo antes da administração de vasoconstritor e largura 4 (Rho = 0,380) e largura 5 (Rho = 0,371); (ii) largura 2 e área mínima de corte transversal 1 antes da administração de vasoconstritor (Rho = 0,380); (iii) fluxo antes da administração de vasoconstritor e volumes nasais de 0-5 cm (Rho = 0,421), 2-5 cm (Rho = 0,393) e área mínima de corte transversal 1 (Rho = 0,375); (iv) largura 4 e volume nasal de 0-5 cm antes da administração do vasoconstritor (Rho = 0,376), volume nasal de 2-5 cm antes do uso de vasoconstritor (Rho = 0,376), áreas mínimas de corte transversal 1 antes da administração de vasoconstritor (Rho = 0,410) e áreas mínimas de corte transversal 1 após o uso do vasoconstritor (Rho = 0,426); (v) largura 5 e largura 1 (Rho = 0,542), largura 2 (Rho = 0,411) e largura 4 (Rho = 0,429). Foram encontradas correlações negativas: (i) largura 4 e resistência inspiratória média (Rho = −0,385); (ii) resistência inspiratória média antes da administração de vasoconstritor e volume de 0-5 cm (Rho = −0,382) e resistência expiratória média antes da administração de vasoconstritor e área mínima de corte transversal 1 (Rho = −0,362). Conclusão Correlações foram encontradas entre a rinometria acústica, a rinomanometria computadorizada e a tomografia computadorizada de feixe cônico em respiradores bucais com atresia maxilar.
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OBJECTIVE To assess the guideline role of preoperative subjective and objective assessment on nasal obstruction in chronic rhinosinusitis(CRS) patient during perioperative period. METHODS The patients with CRS who's chief complaint was nasal obstruction were divided into experimental group and control group according to different doctors. Visual analog scale, rhinomanometry and acoustic rhinometry were used to assess subjective and objective nasal obstruction, and nasal endoscopy and sinus CT examination were applied to evaluate the condition of nasal cavity and nasal sinuses. Patients were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period. Postoperative follow-up were performed in 6 months and 1 year. SPSS21.0 was used for statistical analysis. RESULTS There was no statistical difference in nasal obstruction symptom score, total rhinomanometry before operation between experimental group and control group(P>0.05). There were statistical difference between the 2 groups after operation in nasal obstruction symptom score, total rhinomanometry. At the 2 postoperative time points (6 months, 1 year after operation) compared with preoperative period, significant differences were found in the parameters evaluated between the two groups(P<0.05). The curative effect in different postoperative time showed statistical significance(P<0.05). CONCLUSION Preoperative subjective and objective assessment for nasal obstruction can be used not only in the evaluation of severity and treatment effect, but also in the guideline of perioperative treatment for CRS combined with nasal endoscopy and sinus CT examination, which can improve nasal obstruction and the treatment effect of CRS.
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Objective:To observe the outward flow of low temperature plasma ablation combined inferior turbinate fracture treatment for chronic hypertrophic rhinitis nasal ventilation function. Method:NR6 nasal resistance meter and A1 nasal sound reflection instrument were used to test 40 patients of Hypertrophic rhinitis nasal septum deviation merger before and after operation for one year, recording the nasal airway resistance,0 to 5 cm nasal cavity volume and the nasal minimum cross-sectional area, combine visual analog scale to analyze the changing parameter value, and to analyze the test values between the correlation. Result:Postoperative patients of NCV, NMCA, NS value was higher than that of preoperative, VAS, NAR value compared with preoperative lower (P<0.05); Postoperative VAS was negatively correlated with NCV, NMCA, NS (r=0.472, 0.698, 0.586, P<0.05); VAS was positively related with NAR (r=0.877, P<0.05); Postoperative NAR was negatively correlated with NCV, NMCA and NS (r=-0.464, -0.870, -0.707, P<0.05); there was a positive correlation between postoperative NS and NCV, NMCA (r=0.442, 0.741, P<0.05). Conclusion:On the deflection of nasal septum (lighter, smaller scale, the part of the deflection of a back with no obvious compressive deformation and lateral deflection of inferior turbinate) in patients with chronic hypertrophic rhinitis, low temperature plasma ablation combined offshoring inferior turbinate fracture surgery can effectively improve the nasal ventilation function, there is a good correlation between postoperative test values.
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[ABSTRACT]OBJECTIVETo compare the differences of aerodynamic characteristics of pharyngeal cavity between normal subjects and OSAHS patients, and to study the nasal obstruction in the pathogenesis of the OSAHS.METHODSA total of 60 normal subjects and 60 OSAHS patients were enrolled in this study. Numerical simulation was performed to calculate the airflow dynamic indexes of three sections of pharyngeal cavity. Correlation analysis of the nasal resistance and negative pressure were studied.RESULTSThe average pharyngeal negative pressure and airflow velocity in OSAHS patients were significantly increased than that in normal subjects. The total nasal airway resistance significantly correlated with the average negative pressure of pharyngeal cavity. CONCLUSIONAirflow dynamic indexes of OSAHS patients had significant different pharyngeal aerodynamic characteristics from normal subjects. The increased average negative pressure in pharynx might contribute to the severity of pharyngeal collapse for OSAHS patients. Higher total nasal resistance might play a role in the pathophysiological mechanisms of OSAHS.
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Objective To observe nasal resistance in healthy adult people and patients with obstructive sleep apnea hypopnea syndrome (OSAHS), comparing the changes in nasal resistance after nCPAP treatment, and to explore the role of nasal resistance in development of OSAHS and the effect of nCPAP on nasal resistance. Methods Detection of nasal resistance was performed in 11 healthy people and 40 patients with OSAHS after completion of polysomnography (PSG). Three weeks after treatment with nCPAP, the patients received polysomnography and detection of nasal resistance again. Results Nasal resistance was higher in patients with OSAHS than healthy people [(0.27 ± 0.9)Pa/(cm3·s) vs. (0.21 ± 0.7)Pa/(cm3·s), t=-2.048, and P0.05). MinSO2, AHI and ODI were markedly improved three weeks after nCPAP therapy (P<0.05). Nasal resistance was increased from (0.27 ± 0.1) Pa/(cm3·s) to (0.43 ± 0.3)Pa/(cm3·s) after treatment (t = -2.733, P < 0.05). Conclusions Increased nasal resistance is one of risk factors for pathogenesis of OSAHS. Nasal resistance is not related with the severity of OSAHS. nCPAP can lead to an elevation in nasal resistance.
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Objective To investigate the obstructive sleep apnea syndrome ( OSAHS) associated with nasal resistance.Methods 30 cases with obstructive sleep apneahypopnea syndrome ( OSAHS ) in the OSAHS group, 30 cases with snoring but without OSAHS in the snoring group and 30 cases with normal group based on polysomnog-raphy were detected the nasal resistance.Results The index of thsnoring index[(42.7 ±27.3),(19.4 ±18.5), AHI(38.7 ±30.2),(5.9 ±1.6)and Resl+r(1.63 ±1.11)Pa· s-1· mL-1,(0.72 ±0.31)Pa· s-1· mL-1] in OSAS group and snoring group were significantly higher than those of the normal group ( t=6.451,7.444,7.698,all P0.05),wake times (r=0.083,P>0.05) and lowest SaO2(r=0.105,P>0.05)were not significantly correlated;The cases with OSAS cephalometric.The results suggest majority snoring symptoms significantly more at supine posi-tion in OSAS.Conclusion Nasal resistance increased,which may be associated with the occurrence in patients with OSAHS.
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A finalidade deste artigo é avaliar o efeito da expansão rápida da maxila (ERM) no padrão respiratório. Por intermédio de um caso clínico, será relatado como indivíduos com atresia da maxila e problemas respiratórios podem se beneficiar com a expansão rápida da maxila. Outro aspecto que deve-se salientar é como profissionais da área da saúde, principalmente ortodontistas e otorrinolaringologistas, têm à sua disposição exames complementares para o diagnóstico do paciente com "Respiração Bucal".
The aim of the present investigation is to evaluate the effect of rapid maxillary expansion (RME) on the respiratory pattern. A clinical case is presented to describe how patients with atresic maxilla and respiratory problems can benefit from rapid maxillary expansion. The article highlights that the health professional, mainly the Orthodontist and the Otorhinolaryngologist, may use complementary exams to diagnose a mouth breather patient.
Subject(s)
Humans , Male , Child , Nasal Cavity/abnormalities , Nasal Cavity/pathology , Malocclusion, Angle Class II/therapy , Palatal Expansion Technique , Mouth Breathing/diagnosis , Rhinomanometry , Orthodontics , Respiratory System AbnormalitiesABSTRACT
Os efeitos da disjunção maxilar na resistência nasal e fluxo aéreo têm sido amplamente discutidos na literatura, com controvérsias. Suas indicações esqueléticas e dentárias parecem estar bem claras. Porém, aquelas puramente rinológicas não são justificadas, porque nem sempre resultados positivos são encontrados. Este estudo teve por finalidade avaliar a repercussão da disjunção maxilar ortopédica no aspecto respiratório e rinológico dos pacientes submetidos a esse procedimento.
Rapid maxillary expansion effects on airflow and nasal resistance has been amply discussed in literature, with controversies. Its skeletal and dental indications seem to be clear, however, those sole rhinologic are not justified, because positive results are not always found. This study had as purpose to evaluate the orthopedic rapid maxillary expansion repercussion on respiratory and rhinologic aspects of patients undergoing this procedure.
Subject(s)
Humans , Nasal Cavity , Palatal Expansion Technique , Maxilla , Nasal Provocation Tests , Rhinomanometry , Rhinometry, Acoustic , SpirometryABSTRACT
Por la incertidumbre existente con respecto a la posible relación entre los desórdenes respiratorios y las alteraciones del crecimiento y desarrollo del macizo craneofacial, con esta investigación se pretendió hacer un aporte al conocimiento científico mediante la obtención de datos claves acerca de la elaboración, calibración y validación de instrumentos confiables para la medición del flujo de aire, las caídas asociadas a la presión del aire inspirado y/o espirado y la resistencia nasal, en aras de poder cuantificar los valores de normalidad de la función respiratoria. Para tal efecto se diseñaron, construyeron, calibraron y se utilizaron experimentalmente instrumentos de medición de la función respiratoria. Como resultado de lo anterior, se obtuvieron curvas de calibración, tanto para el flujo de aire como para la diferencia de presión, que presentaron coeficientes de correlación (r) de 0.9997 y 0.9992, respectivamente. Mediante el uso de un espirómetro y un neumotacógrafo junto con transductores de presión conectados a un polígrafo, empleando una muestra por conveniencia compuesta por cuarenta y cuatro sujetos infantiles, con edades que oscilaron entre los seis y los doce años, se realizó un estudio piloto. En experimentos separados sobre los mismos sujetos y el uso dispositivos externos independientes, con el objeto de establecer la partición oral/nasal en la espiración espontánea de los sujetos en reposo se colectaron simultáneamente los gases espirados por vía nasal y oral durante un lapso de ocho minutos. Se registraron curvas de flujo de aire por vía nasal y de diferencias de presión orofaringe-máscara en niños sentados y en reposo. obre los trazados se calcularon el flujo medio de aire durante la inspiración y la diferencia media de presión orofaringe- máscara durante la misma fase, valores con los cuales se calculó la resistencia inspiratoria media de la vía nasal. Los valores de la resistencia nasal obtenida cayeron dentro del rango normal.
The unknown relationship among breathing disorders and development growing of skull and facial bones were the focal point of these research as a form to find key facts trough scientific approach regarding construction, calibrating and testing suitable instruments to measure breathing air flow and pressure air drops associated to inhalation and exhalation, as well as nasal resistance in order to quantify breathing normal values. To obtain these objectives, measure respiratory instruments were designed, build and tested. As a test product, correlated data for airflow and pressure drops calibrated curves at 0.9997 and 0.9992 values were obtained. By use of an expirometer and a pneumotachography machines along with pressure transducers connected to a polygraph, a pilot study was carry out on a by convenience sample of forty four child subjects whose ages raging between six to twelve years old. Using the same sample in separate experiments with external devices, exhalated air was collected by nasal and oral way during eight minutes; in order to achieve oral and nasal partition of subjects exhalation air at rest. Air flow and pressure drops by nasal way in children at rest were registered. Base on the medium records of air flow during inhalation and medium records of pressure drops calculated during the same stage, values which were used to calculate the medium inspiratory resistance of the nasal way. The nasal resistance values calculated within an average of 5.4 cm H2O/l/s, a standard deviation of 1.96 cm H2O/l/ were considerate into the normal range. Results of this pilot study showed low correlation in most of the respiratory connections measured on the studied subjects; future studies must use of a greater sample to obtain more significant values than those showed on these research project.