Single-Sided Peak Nasal Inspiratory Flow as an Adjunct Objective Measure in Functional Septorhinoplasty.

ABSTRACT

OBJECTIVE: Nasal obstruction can negatively impact patient quality of life, which can be alleviated by functional nasal surgery. Quantification of improvement is most commonly evaluated with the use of validated survey instruments but lacks widely utilized objective measures. Herein, we evaluate the utility of single-sided peak nasal inspiratory flow (PNIF) as an objective outcome measure in the evaluation and management of nasal obstruction. METHODS: Adults presenting with nasal obstruction who were recommended septorhinoplasty were included in the study. Single-sided and bilateral PNIF measures, nasal obstruction symptom evaluation (NOSE) scores, surgeon-rated percent nasal obstruction, and nasal obstruction visual analog scale (VAS) scores were recorded preoperatively with Spearman's correlation coefficients (ρ) calculated. Correlation coefficients were also calculated between the change in the above variables from the pre- to postoperative state. RESULTS: One Hundred Fifteen patients were enrolled in the study and underwent septorhinoplasty. Significant correlations between single-sided PNIF and the associated VAS scores of the same laterality were found for the worse (ρ = -0.366; p < 0.001) and better (ρ = -0.313; p < 0.001) breathing sides. Correlations between postoperative improvement in single-sided PNIF and improvement in VAS scores were also found (ρ = -0.330; p = 0.007, ρ = -0.354; p = 0.004). No correlation between NOSE scores and single-sided PNIF was found except in the subgroup of patients presenting with bilateral asymmetric nasal obstruction, in who NOSE scores correlated with worse side PNIF (ρ = -0.369; p = 0.038). CONCLUSIONS: Single-sided PNIF has a better correlation to patients' symptoms as rated by VAS score than bilateral PNIF and may be a useful adjunct objective measure in the evaluation and quantification of improvement in patients undergoing septorhinoplasty. LEVEL OF EVIDENCE Level III Laryngoscope, 2024.