Affiliation:
1. Ear, Nose & Throat Department Newcastle Upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
2. Northern Medical Physics and Clinical Engineering Newcastle Upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
3. Translational and Clinical Research Institute Newcastle University Newcastle upon Tyne UK
4. Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
5. Biostatistics Research Group Newcastle University Newcastle upon Tyne UK
Abstract
ABSTRACTBackgroundThe role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined.ObjectiveTo explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction.MethodsThis is a sub‐study of the NAIROS trial. Participants with nasal obstruction secondary to septal deviation were included in this NAIROS sub‐study. The side of septal deviation, enlargement of inferior turbinate (IT), the need for IT reduction if septoplasty was being performed, the area of septum deflecting into the airway and observer rated airway block (ORAB–arbitrarily divided by <50% and >50% blockage) were assessed by clinicians. The subjective score of nasal obstruction was assessed using the Double Ordinal Assessed Subjective Scale (DOASS). Objective nasal patency measures (e.g., nasal partitioning ratio, [NPR] and PNIF) were measured using PNIF and rhinospirometry.ResultsThe mean NPR for left‐sided, both‐sided and right‐sided septal deviation was −0.35, −0.02 and 0.51, respectively (p < 0.001). There was very weak correlation between the requirement for IT reduction and PNIF change (0.13, p < 0.01). There was no difference in mean PNIF (94 L/min vs. 93 L/min) and mean DOASS (0.33 vs. 0.38) for participants with ORAB rated <50% and >50%. The mean NPR for participants with ORAB >50% was higher than for those with ORAB <50% (0.51 vs. 0.41, p = 0.002). There was strong correlation between the DOASS and NPR (+0.737, p < 0.001). The mean DOASS score for right‐sided, both‐sided and left‐sided septal deviation was 0.32, 0.05 and −0.29, respectively (p < 0.001).ConclusionThis study identified strong relationships between the clinician rated side of septal deflection, the patient reported DOASS and the objective NPR measurements. NPR and the clinician rated degree of airway blockage were concordant.