Razavi Christopher R, Ji Keven, Chen Patricia, Carlson Birgitta, Mace Jess C, Krane Natalie A, Wang Tom D, Smith Timothy L, Loyo Myriam
Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.
Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.
Laryngoscope. 2025 Feb;135(2):641-647. doi: 10.1002/lary.31709. Epub 2024 Aug 19.
Nasal obstruction can negatively impact patient quality of life, which can be alleviated by functional nasal surgery. Quantification of improvement is most commonly evaluated with the use of validated survey instruments but lacks widely utilized objective measures. Herein, we evaluate the utility of single-sided peak nasal inspiratory flow (PNIF) as an objective outcome measure in the evaluation and management of nasal obstruction.
Adults presenting with nasal obstruction who were recommended septorhinoplasty were included in the study. Single-sided and bilateral PNIF measures, nasal obstruction symptom evaluation (NOSE) scores, surgeon-rated percent nasal obstruction, and nasal obstruction visual analog scale (VAS) scores were recorded preoperatively with Spearman's correlation coefficients (ρ) calculated. Correlation coefficients were also calculated between the change in the above variables from the pre- to postoperative state.
One Hundred Fifteen patients were enrolled in the study and underwent septorhinoplasty. Significant correlations between single-sided PNIF and the associated VAS scores of the same laterality were found for the worse (ρ = -0.366; p < 0.001) and better (ρ = -0.313; p < 0.001) breathing sides. Correlations between postoperative improvement in single-sided PNIF and improvement in VAS scores were also found (ρ = -0.330; p = 0.007, ρ = -0.354; p = 0.004). No correlation between NOSE scores and single-sided PNIF was found except in the subgroup of patients presenting with bilateral asymmetric nasal obstruction, in who NOSE scores correlated with worse side PNIF (ρ = -0.369; p = 0.038).
Single-sided PNIF has a better correlation to patients' symptoms as rated by VAS score than bilateral PNIF and may be a useful adjunct objective measure in the evaluation and quantification of improvement in patients undergoing septorhinoplasty.
3 Laryngoscope, 135:641-647, 2025.
鼻塞会对患者的生活质量产生负面影响，而功能性鼻手术可缓解这种影响。改善情况的量化通常使用经过验证的调查工具进行评估，但缺乏广泛应用的客观测量方法。在此，我们评估单侧峰值鼻吸气流量（PNIF）作为评估和管理鼻塞的客观结果指标的效用。
纳入因鼻塞而被建议行鼻中隔鼻成形术的成年患者。记录术前的单侧和双侧PNIF测量值、鼻塞症状评估（NOSE）评分、外科医生评定的鼻塞百分比以及鼻塞视觉模拟量表（VAS）评分，并计算Spearman相关系数（ρ）。还计算了上述变量从术前到术后状态的变化之间的相关系数。
115例患者纳入本研究并接受了鼻中隔鼻成形术。对于呼吸较差（ρ = -0.366；p < 0.001）和较好（ρ = -0.313；p < 0.001）的一侧，发现单侧PNIF与同一侧相关的VAS评分之间存在显著相关性。还发现单侧PNIF术后改善与VAS评分改善之间存在相关性（ρ = -0.330；p = 0.007，ρ = -0.354；p = 0.004）。除了双侧不对称鼻塞患者亚组中NOSE评分与较差侧PNIF相关（ρ = -0.369；p = 0.038）外，未发现NOSE评分与单侧PNIF之间存在相关性。
与双侧PNIF相比，单侧PNIF与VAS评分所评定的患者症状具有更好的相关性，并且可能是评估和量化接受鼻中隔鼻成形术患者改善情况的有用辅助客观指标。
3《喉镜》，135:641 - 647，2025年。
