Use of Acoustic Rhinograms

The usefulness of acoustic rhinography is not completely defined. The technique appears to have promise for quantifying the degree and location of narrowing in the anterior region of the nose. Its advantage over rhinomanometry is that it allows localization of abnormalities, and this may allow better diagnosis and better determination of appropriate surgical procedures. The region most easily evaluated with acoustic rhinometry is the region best evaluated visually. Acoustic rhinometry alone does provide information about the effect of narrowing on resistance. For this, rhinomanometry is necessary.

No single method of evaluating the nasal airway correlates with pathologic findings and the patient's subjective symptoms. Nasal endoscopy and imaging studies provide anatomic display but do not quantify nasal obstruction. Rhinomanometry can be useful in determining whether a documented intranasal deformity increases nasal resistance and therefore causes functional disturbance (13). Acoustic rhinometry can be used for accurate location and quantification of areas of obstruction in the anterior nasal cavity. This technique provides objective data to assess the need for surgical correction, to document postsurgical outcome, and to monitor medical therapy for inflammatory nasal disorders. Because the technique is rapid and noninvasive, it is an ideal method of evaluating possible nasal airway obstruction in children (20). Acoustic rhinometry does not replace previous methods of evaluation of the patency of the nasal cavity but provides objective documentation that is accurate and reproducible.

HIGHLIGHTS

The function of the nasal airways is to warm, humidify, clean, and regulate the flow of inspired air.

The nasal blood vessels are controlled by sympathetic and parasympathetic nerves as well as locally released mediators, which include substance P, histamine, and leukotrienes.

The nasal mucociliary system is essential for the clearance of mucus, debris, and bacteria from the paranasal sinuses and nasal airway.

The three functional regions of the nasal airway for regulation of airflow are the nasal vestibule, the nasal valve, and the nasal cavum.

The nasal valve is the narrowest and highest-resistance segment of the nasal airway.

Rhinomanometry is used for quantifying the resistance of the nasal airway.

A total nasal airway resistance greater than 0.3 Pa/cm3 per second usually is symptomatic.

The types of nasal obstruction identified with rhinomanometry are mucosal obstruction, structural obstruction, and dynamic airway collapse.

Acoustic rhinometry is a method for measuring nasal airway dimensions with reflected sound waves.

Acoustic rhinometry can help identify the location of flow-limiting segments in the nasal airway.

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