The Journal of Laryngology & Otology

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Reversible nasal airway obstruction: does change in nasal peak inspiratory flow following decongestion predict response to topical steroids in chronic rhinosinusitis patients?

N K F Koo Nga1 c1, D Younga2 and G W McGarrya1

a1 Department of Otolaryngology and Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK

a2 Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK

Abstract

Background: Predicting which chronic rhinosinusitis patients have nasal obstruction due to reversible mucosal inflammation could prevent unnecessary surgery.

Aim: To investigate whether the change in nasal peak inspiratory flow following maximal decongestion (i.e. mucosal reversibility) at first visit predicts the response to topical steroids in chronic rhinosinusitis patients, as measured by the 22-item Sinonasal Outcome Test.

Methods: Prospective study of 128 consecutive new adult patients presenting with nasal obstruction due to chronic rhinosinusitis (January 2008 to July 2010). The 22-item Sinonasal Outcome Test questionnaire was administered and the nasal peak inspiratory flow assessed. Following maximal nasal decongestion, the nasal peak inspiratory flow was again tested and the difference calculated. Topical steroids were administered for at least six weeks. The 22-item Sinonasal Outcome Test was then repeated and the difference calculated.

Results: Data were analysed using means and correlation studies (Spearman's rank correlation). There was no correlation between the pre- versus post-decongestion nasal peak inspiratory flow difference and the pre- versus post-steroid 22-item Sinonasal Outcome Test difference, in chronic rhinosinusitis patients with or without nasal polyps.

Conclusion: The difference between pre- and post-decongestion nasal peak inspiratory flow does not predict chronic rhinosinusitis patients' response to topical steroids.

(Accepted March 05 2012)

(Online publication October 11 2012)

Key words

  • Nasal Obstruction;
  • Rhinitis;
  • Sinusitis;
  • Nasal Decongestants;
  • Steroids

Correspondence:

c1 Address for correspondence: Dr N K F Koo Ng, Department of Otolaryngology and Head and Neck Surgery, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G31 2ER, Scotland, UK Fax: +44 (0)141 211 5545 E-mail: nigel12@doctors.org.uk

Footnotes

  Dr N K F Koo Ng takes responsibility for the integrity of the content of the paper

Competing interests: None declared

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