Measurement of nasal patency by acoustic rhinometry in Japanese school children

Influence of Age and Gender on Nasal Airway Patency as Measured by Active Anterior Rhinomanometry and Acoustic Rhinometry

In this study, we aimed to investigate the influences of age and gender on nasal airway patency, as measured by both active anterior rhinomanometry (AAR) and acoustic rhinometry (AR). The nasal airway patency of healthy subjects was evaluated using AAR and AR. In AAR, the subjects generated airflow actively through inspiration and expiration in repetitions of10, while nasal patency was measured at an inspiratory and expiratory reference pressure of 75 Pa. In AR, we assessed the geometry of the nasal cavity through the analysis of sound waves reflected from the nasal cavities in order to measure both cross-sectional areas and nasal volumes. The subjects were divided by gender, with all males and females then grouped by ages of 20–39 years, 40–59 years and ≥60 years. There were 40 subjects in each group. The mean resistance measured by AAR and the cross-sectional areas and nasal volumes measured by AR were not different between the different age groups; however, the cross-sectional areas and nasal volumes were found to be lesser in females than in males. Our results showed that nasal airway patency was not affected by age, while females were shown to have wider nasal passages than males.

Guideline Values for Minimum Nasal Cross-Sectional Area in Children

OBJECTIVE

The purpose was to determine age-specific values of the minimum cross-sectional area of the nasal airway in children without cleft lip or palate and to assess whether gender differences occur with growth in order to develop guidelines for assessment in children with clefts.

PARTICIPANTS

All schoolchildren aged 8 to 17 years who met the research criteria were studied during rest breathing using the pressure-flow technique. The children came from a rural area of 3800 inhabitants. Consecutive age cohorts were used for comparisons.

RESULTS

Nasal cross-sectional area increased in females from 0.38 cm² in 8-year-olds to 0.58 cm² in 17-year-olds. There was a decrease in size at ages 10 to 11 and 14 to 15 years. In males, the area increased from 0.40 to 0.68 cm² and decreased slightly from 9 to 10 and 14 to 15 years. The annual changes were statistically significant in females between 8 and 9 and 11 to 13 years of age, and in males from 11 to 12, 13 to 14, and 15 to 17 years of age. Across gender, the only significant difference occurred at age 16.

CONCLUSIONS

Our results indicate that the increase in nasal airway size is not consistent during growth. Nasal airway size showed almost equal values for both genders in young children but was systematically larger in boys from 14 years of age on. The results refer that by 17 years of age nasal airway may not have reached adult size in males.

Perception and Respiratory Responses of the Upper Airway Mechanism to Added Resistance With Aging

Objectives

To assess breathing behaviors and perception of added respiratory loads in young compared to old individuals, and to determine whether aging affects the perception and response to changes in nasal airway resistance.

Study design

In a clinical study, 40 young (11-20 years) and 40 older (59-82 years) subjects were evaluated during rest breathing and during the application of added airway resistance loads.

Methods

The pressure-flow technique was used to measure airflow rate (mL/s) and oral-nasal pressures (cmH₂O) to calculate nasal resistance (cmH₂O/L/s). To create calibrated resistance loads for the test conditions, we used a device modified from a precision iris diaphragm.

Results

During rest breathing airflow rate was significantly lower for the younger group compared to older group. Using the loading device, 11-20-year-olds detected increased resistance at the level of 2.26 cmH₂O/L/s compared to 4.55 cmH₂O/L/s in 59-82-year-olds. In contrast to the younger group, mean airflow rate was higher during expiration than during inspiration among 59-82-year-olds except at rest breathing.

Conclusions

The data revealed that the perception and respiratory response to increased airway resistance changed with aging. Younger subjects were more sensitive to changes within the airway. In both groups, subjects responded to increased airway resistance by decreasing airflow rate. However, expiratory phase became more active than inspiratory phase only in the older group.

Level of Evidence

N/A.

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.

Physiology and pathophysiology of respiratory mucosa of the nose and the paranasal sinuses

In this review, anatomy and physiology of the respiratory mucosa of nose and paranasal sinuses are summarized under the aspect of its clinical significance. Basics of endonasal cleaning including mucociliary clearance and nasal reflexes, as well as defence mechanisms are explained. Physiological wound healing, aspects of endonasal topical medical therapy and typical diagnostic procedures to evaluate the respiratory functions are presented. Finally, the pathophysiologies of different subtypes of non-allergic rhinitis are outlined together with treatment recommendations.