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Lookup NU author(s): Dr Pavithran Maniam, Dr Alison Bray, Dr Michael DrinnanORCiD, Tony Fouweather, Professor Dawn Teare, Sean Carrie, James O'HaraORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The Author(s). Clinical Otolaryngology published by John Wiley & Sons Ltd. Background: The 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. Objective: To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction. Methods: This 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. Results: The 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). Conclusion: This 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.
Author(s): Maniam P, Bray A, Drinnan M, Fouweather T, Teare M, Carrie S, O'Hara J
Publication type: Article
Publication status: Published
Journal: Clinical Otolaryngology
Year: 2024
Pages: ePub ahead of Print
Online publication date: 08/09/2024
Acceptance date: 23/08/2024
Date deposited: 17/09/2024
ISSN (print): 1749-4478
ISSN (electronic): 1749-4486
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1111/coa.14221
DOI: 10.1111/coa.14221
Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
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