Bermüller Christian, Kirsche Hanspeter, Rettinger Gerhard, Riechelmann Herbert
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Ulm, Ulm, Germany.
Laryngoscope. 2008 Apr;118(4):605-10. doi: 10.1097/MLG.0b013e318161e56b.
Sensitivity and specificity of active anterior rhinomanometry (RMM) and peak nasal inspiratory flow (PNIF) in the diagnosis of functionally relevant structural nasal deformities should be assessed. The reference standard was clinical judgment based on all clinical data available.
Prospective study of diagnostic accuracy at a tertiary rhinologic referral center.
RMM and PNIF were performed on 53 patients with symptomatic nasal stenosis and 40 healthy volunteers. Cut-offs for RMM and PNIF were defined by receiver operating characteristic analysis.
A cut-off between normal and pathological of 700 mL/second for RMM at a transnasal pressure difference of 150 Pa, and of 2,000 mL/second (120 l per minute) for PNIF was calculated. No significant differences in terms of sensitivity of RMM and PNIF (0.77 vs. 0.66), specificity (0.8 vs. 0.8) and diagnostic accuracy (0,79 vs. 0.72) were found.
RMM and PNIF provide valuable information to support clinical decision making. However, with both methods, approximately 25% of symptomatic patients with functionally relevant nasal structural deformity were not detected. A negative test outcome of RMM or PNIF does not exclude a functionally relevant nasal stenosis.
评估主动前鼻测压法（RMM）和鼻吸气峰流量（PNIF）在诊断功能性相关鼻结构畸形中的敏感性和特异性。参考标准是基于所有可用临床数据的临床判断。
在一家三级鼻科转诊中心进行的诊断准确性前瞻性研究。
对53例有症状的鼻狭窄患者和40名健康志愿者进行RMM和PNIF检测。通过受试者工作特征分析确定RMM和PNIF的临界值。
计算得出，在经鼻压差为150帕时，RMM的正常与病理临界值为700毫升/秒，PNIF的临界值为2000毫升/秒（每分钟120升）。RMM和PNIF在敏感性（0.77对0.66）、特异性（0.8对0.8）和诊断准确性（0.79对0.72）方面未发现显著差异。
RMM和PNIF为支持临床决策提供了有价值的信息。然而，两种方法都未检测出约25%有功能性相关鼻结构畸形的有症状患者。RMM或PNIF检测结果为阴性并不能排除功能性相关鼻狭窄。
