Objective measurement and patient-reported evaluation of the nasal
airway -- is correlation dependent on symptoms or on nasal airflow?
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.