Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-27T12:42:17.789Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  11 October 2012

N K F Koo Ng*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK
D Young
Affiliation:
Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK
G W McGarry
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK
*
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

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fokkens, W, Lund, V, Mullol, J. European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl 2007;20:1136Google ScholarPubMed
2Starling-Schwanz, R, Peake, HL, Salome, CM, Toelle, BG, Ng, KW, Marks, GB et al. Repeatability of peak nasal inspiratory flow measurements and utility for assessing the severity of rhinitis. Allergy 2005;60:795800CrossRefGoogle ScholarPubMed
3Holmstrom, M, Scadding, GK, Lund, VJ, Darby, YC. Assessment of nasal obstruction. A comparison between rhinomanometry and nasal inspiratory peak flow. Rhinology 1990;28:191–6Google ScholarPubMed
4Bermuller, C, Kirsche, H, Rettinger, G, Riechelmann, H. Diagnostic accuracy of peak nasal inspiratory flow and rhinomanometry in functional rhinosurgery. Laryngoscope 2008;118:605–10CrossRefGoogle ScholarPubMed
5Hopkins, C, Gillett, S, Slack, R, Lund, VJ, Browne, JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 2009;34:447–54CrossRefGoogle ScholarPubMed
6Fairley, JW, Durham, LH, Ell, SR. Correlation of subjective sensation of nasal patency with nasal inspiratory peak flow rate. Clin Otolaryngol Allied Sci 1993;18:1922CrossRefGoogle ScholarPubMed
7Morrissey, MS, Alun-Jones, T, Hill, J. The relationship of peak inspiratory airflow to subjective airflow in the nose. Clin Otolaryngol Allied Sci 1990;15:447–51CrossRefGoogle ScholarPubMed
8Barnes, ML, Biallosterski, BT, Gray, RD, Fardon, TC, Lipworth, BJ. Decongestant effects of nasal xylometazoline and mometasone furoate in persistent allergic rhinitis. Rhinology 2005;43:291–5Google ScholarPubMed