Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Vaxjo Central Hospital, Vaxjo, Sweden.
Clin Otolaryngol. 2012 Feb;37(1):17-22. doi: 10.1111/j.1749-4486.2011.02420.x.
The correlation between subjective and objective outcomes of nasal obstruction is still a matter of controversy. The aim of this study was to determine the minimal level of side difference in nasal airway resistance (NAR measured by Broms'v(2)) between the two nasal cavities, which could be discerned subjectively by the patient on a visual analogue scale (VAS). Nasal airway resistance was calculated from rhinomanometric measurements of nasal airflow and transnasal pressure after decongestion of the nasal mucosa.
A retrospective study.
ENT department, Vaxjo Central Hospital, Sweden.
We studied 1000 active anterior rhinomanometries from patients with nasal obstructions.
We compared the side difference of nasal airway resistance with the side difference of VAS estimated immediately prior to the rhinomanometry. Each measurement was performed after nasal decongestion.
When the difference in nasal airway resistance between the two nasal cavities was larger than 20° (Broms'v(2)) or R(2) > 0.36 Pa/cm(3) /s, we found a significant correlation between side differences of the objective measurement and the subjective assessment (VAS). With a nasal airway resistance side difference over 20°, an additional 20° difference corresponded to a 0.9 centimetre average VAS change. The more obstructed side of the nose could be determined by VAS in 823 (82.3%) of 1000 patients. Yet, 177 (17.7%) patients had a paradoxical sensation of nasal obstruction with the low resistance side of the nose experienced as the most congested side.
A significant correlation between the side differences of nasal airway resistance and VAS can serve as a supplement to rhinoscopy in decisions about nasal surgery. This study also showed that in 17.7% of patients, there was a negative correlation between subjective and objective evaluations of nasal airway resistance. But in this group, the nasal airway resistance side difference was mostly under 20°.
主观和客观鼻阻塞结果之间的相关性仍然存在争议。本研究的目的是确定两个鼻腔之间的鼻腔气道阻力（通过 Broms'v(2) 测量的）侧差最小水平，患者可以通过视觉模拟量表（VAS）主观地辨别出这种差异。鼻腔气道阻力是从鼻黏膜充血后的鼻流量和经鼻压力的鼻测压法测量值计算得出的。
回顾性研究。
瑞典 Vaxjo 中央医院耳鼻喉科。
我们研究了 1000 例患有鼻阻塞的患者的主动前鼻测压法。
我们将鼻腔气道阻力的侧差与鼻测压法前立即估计的 VAS 侧差进行了比较。每次测量均在鼻腔充血消退后进行。
当两个鼻腔之间的鼻腔气道阻力差异大于 20°（Broms'v(2)）或 R(2) > 0.36 Pa/cm(3) /s 时，我们发现客观测量的侧差与主观评估（VAS）之间存在显著相关性。当鼻腔气道阻力侧差超过 20°时，额外的 20°差异对应于平均 VAS 变化 0.9 厘米。在 1000 例患者中，823 例（82.3%）可以通过 VAS 确定鼻腔阻塞的更阻塞侧，但 177 例（17.7%）患者存在鼻腔阻塞的矛盾感觉，即低阻力侧被体验为最充血的一侧。
鼻腔气道阻力的侧差与 VAS 之间的显著相关性可以作为鼻手术决策中鼻镜检查的补充。本研究还表明，在 17.7%的患者中，主观和客观评估鼻腔气道阻力之间存在负相关。但在这个组中，鼻腔气道阻力侧差大多低于 20°。
