Correlations Between Acoustic Rhinometry, Subjective Symptoms, and Endoscopic Findings in Symptomatic Children With Nasal Obstruction
| Autor: | Hamdy El-Hakim, Mohamed Korayem, Michael P. Major, Andre Isaac, Manisha Witmans, Paul W. Major, Carlos Flores-Mir, Yaser Alrajhi, Noura A. Alsufyani |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Natural Orifice Endoscopic Surgery Rhinometry Acoustic medicine.medical_specialty Adolescent Visual analogue scale medicine.drug_class Comorbidity Adenoid Cohort Studies Age Distribution Sleep Apnea Syndromes Acoustic rhinometry Internal medicine otorhinolaryngologic diseases medicine Humans Medical history Obesity Sex Distribution Child Medical History Taking Nose Asthma business.industry medicine.disease Rhinitis Allergic Causality Deviated nasal septum Decongestant Cross-Sectional Studies medicine.anatomical_structure Otorhinolaryngology Anesthesia Female Surgery Nasal Obstruction business |
| Zdroj: | JAMA Otolaryngology–Head & Neck Surgery. 141:550 |
| ISSN: | 2168-6181 |
| Popis: | IMPORTANCE Nasal obstruction is common in children and difficult to quantify objectively. Symptom quantification is paramount for surgical and medical decision making. Acoustic rhinometry is a relatively new technique aimed at the objective assessment of nasal obstruction. There is no standardized method for the objective assessment of the pediatric nasal airway. OBJECTIVE To explore the correlations between acoustic rhinometry (AR), subjective symptoms, and endoscopic findings in children presenting with nasal obstruction. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, exploratory, diagnostic study of prospectively collected data from a multidisciplinary airway clinic (pulmonology, orthodontics, and otolaryngology) database at a tertiary academic referral center. Data were collected over a 2-year period (2010-2012) from 65 nonsyndromic children (38 boys) 7 years and older (mean [SD] age, 10.3 [2.5] years [range, 7-14 years]), presenting with persistent nasal obstructive symptoms for at least 1 year, without signs and symptoms of sinus disease. INTERVENTIONS We collected patient demographics and medical history information including allergy, asthma, and sleep-disordered breathing. Subjective nasal obstruction was scored using a visual analog scale (VAS). Sleep-disordered breathing was assessed using overnight pulse oximetry. The adenoid size, septal position, and visual severity of chronic rhinitis (endoscopic rhinitis score [ERS]) were rated on nasal endoscopy by 2 independent reviewers and validated by agreement. Acoustic rhinometry (AR) was undertaken before and after use of a decongestant. MAIN OUTCOMES AND MEASURES Correlation and multiple regression analyses were performed to explore interrelationships between subjective nasal obstruction VAS, AR, and nasal endoscopy. RESULTS Among the 65 patients, 28 (43%) had symptoms of sleep-disordered breathing, 14 (22%) had allergic rhinitis, 10 (15%) had asthma, 27 (41%) had grade 3 or 4 adenoidal obstruction, 28 (43%) had an ERS of 2, 6 (9%) had an ERS of 3, and 19 (29%) had septal deviation. Significant correlations were found between subjective nasal obstruction VAS score and ERS (r = -0.364, P = .003), ERS and minimal cross-sectional area before decongestion (r = -0.278, P = .03), and adenoid size and calculated nasal resistance after decongestion (r = 0.430, P |
| Databáze: | OpenAIRE |
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