Shtina I E, Savinkov M A, Valina S L, Ustinova O Yu
Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, Russia.
Perm State National Research University, Perm, Russia.
Vestn Otorinolaringol. 2023;88(1):57-63. doi: 10.17116/otorino20228801157.
Objective diagnostics of nasal breathing disorders in children is a vital issue given frequent inconsistency between patients' subjective feelings and actual nasal patency. Active anterior rhinomanometry (AAR) is an objective procedure and the golden standard for nasal breathing evaluation. But still, there are no actual data in literature on relevant criteria used to evaluate nasal breathing in children.
To determine reference values for indicators evaluated by active anterior rhinomanometry in Caucasian children aged 4-14 based on statistical data.
Overall, we examined 659 healthy children of both sexes who were divided into 7 groups as per their height. All children included into our research underwent AAR according to the conventional procedure. AAR indicators (Summary Flow left, Summary Flow right, Summary Flow, Summary Resistance left, Summary Resistance right and Summary Resistance Flow) are given as median (Me) and values of 2.5, 25, 75, and 97.5 percentiles.
We determined direct moderate, significant and strong correlations between summary speed of the flow and resistance in both nasal passages and separate speeds of the flow and right and left resistance in inhalation and exhalation (=0.46-0.98, <0.001). We also established weak correlations between AAR indicators and age (= -0.08-0.11), and between ARR indicators and height (= -0.07-0.15). Reference values for AAR indicators were successfully determined.
AAR indicators are likely to be determined bearing a child's height in mind. Determined reference intervals can be applied in clinical practice.
鉴于患者主观感受与实际鼻腔通畅情况之间经常存在不一致,儿童鼻腔呼吸障碍的客观诊断是一个至关重要的问题。主动前鼻测压法(AAR)是一种客观的检查方法,也是鼻腔呼吸评估的金标准。但是,文献中仍然没有关于用于评估儿童鼻腔呼吸的相关标准的实际数据。
基于统计数据确定4至14岁白种儿童主动前鼻测压法评估指标的参考值。
我们共检查了659名健康儿童,根据身高将他们分为7组。纳入研究的所有儿童均按照常规程序进行了主动前鼻测压。主动前鼻测压指标(左总流量、右总流量、总流量、左总阻力、右总阻力和总阻力流量)以中位数(Me)以及第2.5、25、75和97.5百分位数表示。
我们确定了两个鼻腔通道的总流速与阻力之间以及吸气和呼气时单独的流速与左右阻力之间存在直接的中度、显著和强相关性(=0.46 - 0.98,<0.001)。我们还发现主动前鼻测压指标与年龄之间存在弱相关性(= -0.08 - 0.11),以及主动前鼻测压指标与身高之间存在弱相关性(= -0.07 - 0.15)。成功确定了主动前鼻测压指标的参考值。
确定主动前鼻测压指标时可能需要考虑儿童的身高。确定的参考区间可应用于临床实践。