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Monitoring fluctuations in nasal patency in children: acoustic rhinometry versus rhinonygrometry

Published online by Cambridge University Press:  29 June 2007

Edward W. Fisher*
Affiliation:
Professional Unit, The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London Department of Otolaryngology, ddenbrooke's Hospital, Hills Road, Cambridge, UK.
Christopher R. Palmer
Affiliation:
Department of Community Medicine. University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, UK
Valerie J. Lund
Affiliation:
Professional Unit, The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London
*
Mr Edward W. Fisher, M.A., F.R.C.S., Consultant Otorhinolaryngologist, ENT Department, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS

Abstract

Simple rhinohygrometry and passive rhinomanometry studies have suggested that the ‘nasal cycle’ in children is often different in pattern of that of adults and experimental animals. We aimed to establish whether this assertion was correct, using a reliable and sensitive method, acoustic rhinometry (AR), and to compare results with those of simple rhinohygrometry (RH). Healthy children with no evidence of nasal disease were examined (n = 15; age range three to 10 years; mean age six years). Simultaneous recordings using AR and RH were made on each child every 10–15 minutes over two to four hour periods. Six children underwent nine additional AR studies on separate occasions. ‘Classical’ reciprocal alternating patterns were evident in 80 per cent (12/15) AR and 53 per cent (8/15) RH studies, ‘in concert’ patterns in seven per cent (1/15) AR and 20 per cent (3/15) RH studies and ‘irregular’ patterns in 13 per cent (2/15) AR and 27 per cent (4/15) RH studies. The agreement between the two methods was 47 per cent, with a kappa (K) value of −0.17 (poor agreement compared to chance). Agreements between the acoustic rhinometry parameters were ‘fair’ for all data (K = 0.34) and excellent (K = 1.0) if irregular patterns were ignored. Repeated studies showed that the pattern of fluctuation varies within any particular individual. The nasal cycle is similar in pattern in children and adults, and acoustic rhinometry is currently the method of choice to further investigate and clarify this phenomenon.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

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References

Altman, D. G. (1991) Practical Statistics for Medical Research. (Altman, D. G., ed.), Chapman and Hall, London, pp 403409.Google Scholar
Bojsen-Moller, F., Fahrenkrug, J. (1971) Nasal swell-bodies and cyclic changes in the air passage of the rat and rabbit nose. Journal of Anatomy 110: 2537.Google ScholarPubMed
Canter, R. J. (1986) A non-invasive method of demonstrating the nasal cycle using flexible liquid crystal thermography. Clinical Otolaryngology 11: 329336.CrossRefGoogle ScholarPubMed
Eccles, R., Maynard, R. L. (1975) Studies on the nasal cycle in the immobilized pig. Journal of Physiology 247: 1P2P.Google ScholarPubMed
Fisher, E. W., Scadding, G. K., Lund, V. J. (1993) The role of acoustic rhinometry in studying the nasal cycle. Rhinology 31: 5761.Google ScholarPubMed
Fisher, E. W., Liu, M., Lund, V. J. (1994a) The nasal cycle after deprivation of airflow: a study of laryngectomy patients using acoustic rhinometry. Acta Otolaryngologica 114: 443446.CrossRefGoogle ScholarPubMed
Fisher, E. W., Lund, V. J., Scadding, G. K. (1994b)Acoustic rhinometry in rhinological practice: discussion paper. Journal of the Royal Society of Medicine 87: 411413.CrossRefGoogle ScholarPubMed
Fisher, E. W., Morris, D. P., Biemans, J. M. A., Palmer, C. R., Lund, V. J. (1995a) Practical aspects of acoustic rhinometry: problems and solutions. Rhinology 33: (in press).Google ScholarPubMed
Fisher, E. W., Liu, M., Lund, V. J. (1995b) Airflow and the nasal cycle: nasal patency fluctuations after laryngectomy. American Journal of Rhinology (in press).CrossRefGoogle Scholar
Gertner, R., Podoshin, L., Fradis, M. (1984) A simple method of measuring the nasal airway in clinical work. Journal of Laryngology and Otology 98: 351355.CrossRefGoogle ScholarPubMed
Gilbert, A. N., Rosenwasser, A. M. (1987) Biological rhythmicity of nasal airway patency: a re-examination of the nasal cycle. Acta Otolaryngologica 104: 180186.CrossRefGoogle ScholarPubMed
Glatzel, P. (1901) Zur Prufung der Luftdurchgangigkeit der Nase. Therapeutische Gegenwart 42: 348351.Google Scholar
Grymer, L. E., Hilberg, O., Elbrønd, O., Pedersen, O. F. (1989) Acoustic rhinometry: evaluation of the nasal cavity with septal deviations, before and after septoplasty. Laryngoscope 99: 11801187.CrossRefGoogle ScholarPubMed
Hasegawa, M., Kern, E. B. (1977) The human nasal cycle. Mayo Clinic Proceedings 52: 2834.Google ScholarPubMed
Hasegawa, M., Kern, E. B. (1990) Variations in nasal resistance (nasal cycle): does it influence the indications for surgery? Facial Plastic Surgery 7: 298306.CrossRefGoogle Scholar
Havas, T. G., Cole, P., Gullane, P., Kassel, R., Kamino, D. (1987) The nasal cycle after laryngectomy. Acta Otolaryngologica 103: 111116.CrossRefGoogle ScholarPubMed
Hilberg, O., Jackson, A. C., Swift, D. L., Pedersen, O. F. (1989) Acoustic rhinometry: evaluation of nasal cavity geometry by acoustic reflection. Journal of Applied Physiology 66: 295303.CrossRefGoogle ScholarPubMed
Kayser, R. (1895) Die exacte messung der luftdurchgangikeit der nase (Uber den weg der athmungsluft in der nase). Archiv fur Laryngologie und Rhinologie 3: 101120.Google Scholar
Keuning, J. (1968) On the nasal cycle. International Rhinology 6: 99136.Google Scholar
Lenders, H., Pirsig, W. (1992) Acoustic rhinometry in studying the nasal cycle in children. Proceedings of the 2nd International Conference of the European Working Group for Paediatric Otorhinolaryngology,Sirmione, Italy,Elsevier Science Publishers,Amsterdam, pp 334337.Google Scholar
Lund, V. J. (1989) Objective assessment of nasal obstruction. Otolaryngologic Clinics of North America 22: 279290.CrossRefGoogle ScholarPubMed
Stoksted, P. (1952) The physiologic cycle of the nose under normal and pathologic conditions. Acta Otolaryngologica 42: 175179.CrossRefGoogle ScholarPubMed
Van Cauwenberge, P., Deleye, L. (1984) Nasal cycle in children. Archives of Otolaryngology, Head and Neck Surgery 110: 108110.CrossRefGoogle ScholarPubMed
Zwaardemaker, H. (1894) Athembeschlag als Hulfmittel zur Diagnose der nasalen Stenose. Archiv fur Laryngologie und Rhinologie 1: 174177.Google Scholar