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Objective measurement and patient-reported evaluation of the nasal airway -- is correlation dependent on symptoms or on nasal airflow?
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  • Rui Xavier,
  • Sofia Azeredo,
  • Dirk Jan Menger,
  • Henrique Carvalho,
  • Jorge Spratley
Rui Xavier
Universidade do Porto Instituto de Ciencias Biomedicas Abel Salazar
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Sofia Azeredo
Universidade Nova de Lisboa Faculdade de Ciencias Medicas
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Dirk Jan Menger
University Medical Center Utrecht
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Henrique Carvalho
Universidade do Porto Instituto de Ciencias Biomedicas Abel Salazar
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Jorge Spratley
Universidade do Porto Faculdade de Medicina
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Abstract

Abstract Background: Evidence showed that the sensation of nasal breathing is related to variations in nasal mucosa temperature produced by airflow. An appropriate nasal airflow is necessary for changing mucosal temperature. Therefore, the correlation between objective measurements of nasal airflow and patient-reported evaluation of nasal breathing should be dependent on the level of nasal airflow. Objectives: To find if the correlation between patient-reported assessment of nasal breathing and objective measurement of nasal airflow is dependent on the severity of symptoms of nasal obstruction or on the level of nasal airflow. Methods: The airway of 79 patients was evaluated using NOSE score and peak nasal inspiratory flow (PNIF). Three subgroups were created based on NOSE and three subgroups were created based on PNIF level to find if correlation was dependent on nasal symptoms or airflow. Results: The mean value of PNIF for the 79 patients was 92.6 l/min (SD 28.1 l/min). The mean NOSE score was 48.4 (SD 24.4). The correlation between PNIF and NOSE was statistically significant (p=0.03), but with a weak association between the two variables (r=-0.248). Evaluation of correlation based on symptoms demonstrated a weak or very weak association in each subgroup (r=-0.250, r=-0.007, r=-0.104). Evaluation of correlation based on nasal airflow demonstrated a very weak association for the subgroups with middle-level and high PNIF values (r=-0.190, r=-0.014), but a moderate association for the subgroup with low PNIF values (r=-0.404). Conclusions: This study demonstrated a weak correlation between NOSE scores and PNIF values in patients non-selected according to symptoms of nasal obstruction or to airflow. It demonstrated that patients with symptoms of nasal obstruction have different levels of nasal airflow and that low nasal airflow prevents the sensation of good nasal breathing. Therefore, patients with symptoms of nasal obstruction may require improving nasal airflow to improve nasal breathing sensation.

Peer review status:Published

23 Sep 2020Submitted to Clinical Otolaryngology
25 Sep 2020Submission Checks Completed
25 Sep 2020Assigned to Editor
03 Oct 2020Reviewer(s) Assigned
12 Oct 2020Review(s) Completed, Editorial Evaluation Pending
25 Oct 2020Editorial Decision: Revise Major
30 Nov 20201st Revision Received
01 Dec 2020Assigned to Editor
01 Dec 2020Submission Checks Completed
04 Dec 2020Reviewer(s) Assigned
10 Dec 2020Review(s) Completed, Editorial Evaluation Pending
13 Dec 2020Editorial Decision: Revise Minor
27 Dec 20202nd Revision Received
31 Dec 2020Submission Checks Completed
31 Dec 2020Assigned to Editor
01 Jan 2021Reviewer(s) Assigned
13 Jan 2021Review(s) Completed, Editorial Evaluation Pending
16 Jan 2021Editorial Decision: Accept
03 Feb 2021Published in Clinical Otolaryngology. 10.1111/coa.13726