Acoustic rhinometry, rhinomanometry and visual analogue scale before and after septal surgery: a prospective 10-year follow-up.

OBJECTIVES: The aim of the study was to compare rhinomanometry, acoustic rhinometry and subjective estimation of the nasal obstruction before and after septoplasty and to evaluate the long-term results of septal surgery. DESIGN: Prospective long-term follow-up, before and after septoplasty. SETTING: University tertiary-care hospital, referral centre. PARTICIPANTS: The study included 30 adult patients who were operated on because of septal deviation. MAIN OUTCOME MEASURES: Pre-operatively, acoustic rhinometry and active anterior rhinomanometry were performed on each subject after decongestion of the nose. A visual analogue scale for unilateral nasal obstruction was filled in by the patients. The measurements were repeated both 6 months and 10 years post-operatively. RESULTS: A significant change in acoustic values was found during the long-term follow-up of 10 years. The mean minimal cross-sectional area on the more obstructive side was 0.35 cm(2) pre-operatively. Six months after operation, it was 0.52 cm(2), and 10 years after operation, it was 0.68 cm(2). The mean resistance fell from pre-operative 1.16 Pa/mL/s to 0.41 Pa/mL/s during the first 6 months, but rose again to 1.21 Pa/mL/s after 10 years. Despite a tendency of improvement, no statistically significant change was found between pre-operative and postoperative values in VAS. Six months after operation 69% of the patients were satisfied with the result, and after ten years the amount of satisfied patients was 83%. CONCLUSIONS: We found an increase in acoustic values, but an increase in nasal resistance in the long-term follow-up. Other factors than nasal area may have an impact on nasal resistance and the feeling of nasal obstruction. The small size on the sample interfered with the results.

Reference values for acoustic rhinometry in children at baseline and after decongestion.

BACKGROUND: Acoustic rhinometry is widely used for objective evaluation of nasal dimensions. However, there is a lack of agreement on the normative values in children at baseline, and especially after decongestion. The purpose of this study was to determine the reference values for Finnish school children for acoustic rhinometry in non-decongested and decongested noses, and to find out which of the potential predictors (age, sex, body surface area (BSA) and height) would be the most useful one(s). METHODOLOGY: The study included 124 children aged between 6.90 and 13.84 years with no permanent nasal symptoms. RESULTS: At baseline, the mean total minimal cross-sectional area (MCA) was 0.752 cm2, and the mean total volume between 0 - 3 cm (VOL) was 4.00 cm3. After decongestion, the total MCA was 0.794 cm2, and the VOL was 4.38 cm3. There was a significant correlation between MCA and age, between VOL and height, and between VOL and BSA at baseline and after decongestion. We found no difference in the values between boys and girls. CONCLUSIONS: We conclude that acoustic rhinometry is a suitable objective method to monitor the changes in mucosal swelling and nasal obstruction in children. Age and height or BSA of a child can be suggested as predictive factors.

Correlation between acoustic rhinometry and visual analogue scale in children with no nasal symptoms: a prospective cohort study.

OBJECTIVES: Acoustic rhinometry is an objective tool to evaluate nasal obstruction. The aim of this study was to evaluate the usefulness of visual analogue scale (VAS) as a subjective tool for nasal obstruction and the correlation between acoustic rhinometry and VAS in children with no nasal symptoms. DESIGN: Unilateral acoustic values and VAS were measured at baseline and after decongestion of the nose. SETTING: Tertiary academic hospital. PARTICIPANTS: The study included 124 children aged between 7 and 14 years with no permanent nasal symptoms. RESULTS: At baseline, the mean minimal cross-sectional area on the right side was 0.392 cm(2) (sd 0.094), and on the left side 0.360 cm(2) (sd 0.093), whereas the mean VAS on the right side was 7.43 (sd 2.50) and on the left side 6.81 (sd 3.01). After decongestion, the mean minimal cross-sectional area on the right and left sides were 0.421 cm(2) (sd 0.087) and 0.373 cm(2) (sd 0.11), respectively, whereas the mean VAS on the right and left sides were 8.77 (sd 2.02) and 8.54 (sd 2.14), respectively. At baseline, a significant correlation was found between VAS and minimal cross-sectional area, but no correlation was found between VAS and acoustic values after decongestion. CONCLUSIONS: We conclude that VAS shows potential as a subjective tool to investigate nasal obstruction in children over 7 years of age. There was a correlation between VAS and acoustic rhinometry in children with no nasal symptoms at baseline. No correlation was found in children with decongested normal nasal airways.

Mediastinoscopy--its role and value today in the differential diagnosis of mediastinal pathology.

Mediastinoscopy has been an important method in the differential diagnosis of mediastinal pathology since it was presented by Carlens in 1959. Present investigation methods in radiology such as computed tomography and magnetic resonance imaging as well as the new developments in ultrasonography have resulted in a decrease in the number of mediastinoscopies performed. In addition, better results of fine-needle aspiration and core-needle biopsy investigations together with new techniques in thoracoscopy have brought alternative possibilities in examining mediastinal masses. To evaluate the role of mediastinoscopy today, a retrospective study was conducted comprising 249 consecutive patients who had undergone mediastinoscopy in the years 1989 1997 at Turku University Central Hospital. Mediastinoscopy was technically possible in 229 of the 249 cases (92.0%) and a definitive diagnosis was obtained in 210 cases (84.3%). The mortality rate was zero and only 13 complications (5.2%) were reported. Six cases of paresis of the left recurrent nerve were reported, four of which were temporary. There were also five minor intraoperative and two postoperative bleedings, which were easily controlled. We still consider mediastinoscopy as a safe and efficient way of examining mediastinal pathology.

A new Finnish computerized rhinomanometer.

We introduce a new sophisticated Finnish rhinomanometer in which the need for routine work has been minimized. Technical information about the instrument is given, recording procedure is described and a normal material and reproducibility test is analyzed.