Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T11:35:00.207Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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