Rhinoresistometry as a Cost-Efficient and Time-Saving Alternative to Acoustic Rhinometry for Longitudinal Assessment of Nasal Patency in Orthognathic Surgery.

Rhinoresistometry (RRM) is implemented along with active anterior rhinomanometry (AAR) and can evaluate nasal dimensions [hydraulic diameter (HD)]. As acoustic rhinometry (AR) is time-consuming, the authors investigated if RRM can be an efficient alternative to AR in nasal dimension assessment in orthognathic surgery. In patients undergoing maxillary advancement and impaction (cases) and removal of maxillary cysts (controls), the authors evaluated RRM and AR, before and 1 year after surgery. Furthermore, the authors investigated the correlation of HD with Nasal Obstruction Symptom Evaluation score and volume by computed tomography and AAR. Lastly, the authors measured RMM reproducibility by the Bland-Altman agreement method in controls. In 14 cases, AR and RMM revealed a significant increase on both sides (all P < 0.011) and the right side, respectively (P = 0.028). The authors noted no changes in 14 controls. Hydraulic diameter correlated only with AAR (most P < 0.004). Acoustic rhinometry lasted ~4 minutes before or after decongestion. In controls, HD after surgery was as large (1.05 times larger) as before surgery (up to 39% error rates). Rhinoresistometry can reproducibly assess nasal dimension changes in orthognathic surgery in a way that is different from AR and correlates with nasal function. Rhinoresistometry can help clinicians avoid AR and save significant time, as well as financial and human resources.

The long-term effect of maxillary advancement and impaction on subjective and objective nasal patency: A retrospective case-control study.

The aim of this study was to investigate the change of nasal patency after maxillary advancement and impaction (MAXADV + IMP) in subjects with skeletal class III malocclusion (cases) and after removal of maxillary cysts in close proximity to the nasal floor in subjects that served as controls. NOSE score, volume derived by computed tomography (VOL), and acoustic rhinometry and rhinomanometry were retrospectively evaluated, before and one year after surgery. The movement of specific landmarks was also measured. NOSE score did not change after surgery, neither in 17 cases (p = 0.10) nor in 17 controls (p = 0.14). In cases, VOLpostop (10088 ± 4200 mm3) was significantly higher than VOLpreop (7807 ± 3721 mm3; p = 0.036). Maxillary advancement and inferior displacement of the ventral maxilla were noted by the movement of incisive foramen in the coronal (3.9 ± 5.4; p = 0.011) and Frankfurt Horizontal plane (2.2 ± 2.0; p = 0.001), respectively. In controls, VOLpostop (9749 ± 3654 mm3) was also significantly higher than VOLpreop (8473 ± 2624 mm3; p = 0.050). Cross-sectional areas, nasal flow and nasal resistance changed significantly after surgery in cases (6/30 pairs; p < 0.018), but not in controls (all p > 0.066). MAXADV + IMP increased nasal patency, but did not change the feeling of nasal breathing. Physicians should proceed with caution when informing patients about improvement of nasal breathing after MAXADV + IMP.