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Total nasal airway resistance while sitting predicts airway collapse when lying down

Published online by Cambridge University Press:  27 October 2020

A Karlsson ,
M Persson ,
A-C Mjörnheim ,
G Gudnadottir  and
J Hellgren
A Karlsson
Affiliation:
Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
M Persson
Affiliation:
Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
A-C Mjörnheim
Affiliation:
Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
G Gudnadottir
Affiliation:
Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
J Hellgren*
Affiliation:
Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
*
Author for correspondence: Dr Johan Hellgren, Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, SE-413 45Göteborg, Sweden E-mail: johan.hellgren@gu.se Fax: +46 3182 5679
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Abstract

Background

Nasal obstruction when lying down is a common complaint in patients with chronic nasal obstruction, but rhinomanometry is typically performed in the sitting position. This study aimed to analyse whether adding rhinomanometry in a supine position is a useful examination.

Method

A total of 41 patients with chronic nasal obstruction underwent rhinomanometry and acoustic rhinometry, sitting and supine, before and after decongestion, as well as an over-night polygraphy.

Results

Total airway resistance was measurable in a supine position in 48 per cent (14 of 29) of the patients with total airway resistance of equal to or less than 0.3 Pa/cm3/second when sitting and in none (0 of 12) of the patients with total nasal airway resistance of more than 0.3 Pa/cm3/second when sitting. After decongestion, this increased to 83 per cent and 58 per cent, respectively.

Conclusion

Increased nasal resistance when sitting predicts nasal breathing problems when supine. Rhinomanometry in a supine position should be performed to diagnose upper airway collapse when supine.

Keywords

Nasal ObstructionRhinomanometryAcoustic RhinometrySupine PositionDisease, Nose
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 10 , October 2020 , pp. 917 - 924
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Dr J Hellgren takes responsibility for the integrity of the content of the paper

References

Shedden, A. Impact of nasal congestion on quality of life and work productivity in allergic rhinitis: findings from a large online survey. Treat Respir Med 2005;4:439–4610.2165/00151829-200504060-00007CrossRefGoogle ScholarPubMed
Young, T, Finn, L, Kim, H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997;99:S757–6210.1016/S0091-6749(97)70124-6CrossRefGoogle ScholarPubMed
Virkkula, P, Maasilta, P, Hytonen, M, Salmi, T, Malmberg, H. Nasal obstruction and sleep-disordered breathing: the effect of supine body position on nasal measurements in snorers. Acta Otolaryngol 2003;123:648–5410.1080/00016480310001493CrossRefGoogle ScholarPubMed
Fouke, JM, Jackson, AC. Acoustic rhinometry: effects of decongestants and posture on nasal patency. J Lab Clin Med 1992;119:371–6Google ScholarPubMed
Roithmann, R, Demeneghi, P, Faggiano, R, Cury, A. Effects of posture change on nasal patency. Braz J Otorhinolaryngol 2005;71:478–8410.1016/S1808-8694(15)31203-9CrossRefGoogle ScholarPubMed
Hellgren, J, Yee, BJ, Dungan, G, Grunstein, RR. Altered positional regulation of nasal patency in patients with obstructive sleep apnoea syndrome. Eur Arch Otorhinolaryngol 2009;266:83–710.1007/s00405-008-0701-1CrossRefGoogle ScholarPubMed
Preece, M, Eccles, R. The effect of pressure and warmth applied to the axilla on unilateral nasal airway resistance and facial skin temperature. Acta Otolaryngol 1993;113:777–8110.3109/00016489309135900CrossRefGoogle ScholarPubMed
Lundqvist, GR, Pedersen, OF, Hilberg, O, Nielsen, B. Nasal reaction to changes in whole body temperature. Acta Otolaryngol 1993;113:783–810.3109/00016489309135901CrossRefGoogle ScholarPubMed
Forsyth, RD, Cole, P, Shephard, RJ. Exercise and nasal patency. J Appl Physiol Respir Environ Exerc Physiol 1983;55:860–5Google ScholarPubMed
Ko, JH, Kuo, TB, Lee, GS. Effect of postural change on nasal airway and autonomic nervous system established by rhinomanometry and heart rate variability analysis. Am J Rhinol 2008;22:159–6510.2500/ajr.2008.22.3143CrossRefGoogle ScholarPubMed
Riechelmann, H, Krause, W. Autonomic regulation of nasal vessels during changes in body position. Eur Arch Otorhinolaryngol 1994;251:210–310.1007/BF00628425CrossRefGoogle ScholarPubMed
Davies, AM, Eccles, R. Reciprocal changes in nasal resistance to airflow caused by pressure applied to the axilla. Acta Otolaryngol 1985;99:154–910.3109/00016488509119158CrossRefGoogle ScholarPubMed
Rundcrantz, H. Posture and congestion of nasal mucosa in allergic rhinitis. Objective measure of effect of specific treatment. Acta Otolaryngol 1964;58:283–710.3109/00016486409121389CrossRefGoogle ScholarPubMed
Altissimi, G, Gallucci, L, Rossetti, M, Simoncelli, C. Diagnosing nasal hyperreactivity with positional rhinomanometry. Ann Otol Rhinol Laryngol 1996;105:901–410.1177/000348949610501111CrossRefGoogle ScholarPubMed
Clement, PAR, Gordts, F, Standardisation, Committee on Objective Assessment of the Nasal Airway IRS, and ERS. Consensus report on acoustic rhinometry and rhinomanometry. Rhinology 2005;43:169–79Google ScholarPubMed
Chaaban, M, Corey, JP. Assessing nasal air flow: options and utility. Proc Am Thorac Soc 2011;8:70–810.1513/pats.201005-034RNCrossRefGoogle ScholarPubMed
Hueto, J, Santaolalla, F, Sanchez-Del-Rey, A, Martinez-Ibarguen, A. Usefulness of rhinomanometry in the identification and treatment of patients with obstructive sleep apnoea: an algorithm for predicting the relationship between nasal resistance and continuous positive airway pressure. a retrospective study. Clin Otolaryngol 2016;41:750–710.1111/coa.12639CrossRefGoogle ScholarPubMed
Toh, ST, Lin, CH, Guilleminault, C. Usage of four-phase high-resolution rhinomanometry and measurement of nasal resistance in sleep-disordered breathing. Laryngoscope 2012;122:2343–910.1002/lary.23441CrossRefGoogle ScholarPubMed
Stroud, RH, Wright, ST, Calhoun, KH. Nocturnal nasal congestion and nasal resistance. Laryngoscope 1999;109:1450–310.1097/00005537-199909000-00018CrossRefGoogle ScholarPubMed
Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:1–1210.4193/Rhino50E2CrossRefGoogle ScholarPubMed
Merkle, J, Kohlhas, L, Zadoyan, G, Mosges, R, Hellmich, M. Rhinomanometric reference intervals for normal total nasal airflow resistance. Rhinology 2014;52:292–9Google ScholarPubMed
Andre, RF, Vuyk, HD, Ahmed, A, Graamans, K, Nolst Trenite, GJ. Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol 2009;34:518–2510.1111/j.1749-4486.2009.02042.xCrossRefGoogle ScholarPubMed
Bjerg, A, Ekerljung, L, Middelveld, R, Dahlen, SE, Forsberg, B, Franklin, K et al. Increased prevalence of symptoms of rhinitis but not of asthma between 1990 and 2008 in Swedish adults: comparisons of the ECRHS and GA(2)LEN surveys. PLoS One 2011;6:e1608210.1371/journal.pone.0016082CrossRefGoogle Scholar
Samolinski, BK, Grzanka, A, Gotlib, T. Changes in nasal cavity dimensions in children and adults by gender and age. Laryngoscope 2007;117:1429–3310.1097/MLG.0b013e318064e837CrossRefGoogle ScholarPubMed
Hellgren, J, Toren, K, Balder, B, Palmqvist, M, Lowhagen, O, Karlsson, G. Increased nasal mucosal swelling in subjects with asthma. Clin Exp Allergy 2002;32:64–910.1046/j.0022-0477.2001.01253.xCrossRefGoogle ScholarPubMed
Gaga, M, Lambrou, P, Papageorgiou, N, Koulouris, NG, Kosmas, E, Fragakis, S et al. Eosinophils are a feature of upper and lower airway pathology in non-atopic asthma, irrespective of the presence of rhinitis. Clin Exp Allergy 2000;30:663–910.1046/j.1365-2222.2000.00804.xCrossRefGoogle ScholarPubMed
Rimmer, J, Greenwood, A, Bartlett, D, Hellgren, J. Nasal steroids improve regulation of nasal patency in asthma and mild rhinitis: a randomised, cross-over trial. Eur Arch Otorhinolaryngol 2012;269:1133–810.1007/s00405-011-1803-8CrossRefGoogle ScholarPubMed
Grymer, LF, Hilberg, O, Pedersen, OF. Prediction of nasal obstruction based on clinical examination and acoustic rhinometry. Rhinology 1997;35:53–7Google ScholarPubMed
Eccles, R, Jones, AS. The effect of menthol on nasal resistance to air flow. J Laryngol Otol 1983;97:705–910.1017/S002221510009486XCrossRefGoogle ScholarPubMed