1. Objective diagnosis of internal nasal valve collapse by four‐phase rhinomanometry
- Author
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Pierre Gagnieur, Maxime Fieux, Bruno Louis, Emilie Béquignon, Sophie Bartier, Delphine Vertu‐Ciolino, Louis, Bruno, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), IMRB - 'Biomechanics and Respiratory Apparatus' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Biomécanique & Appareil Respiratoire (BAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Service d'ORL et de Chirurgie Cervico-Faciale, CHI Créteil, Service d'ORL et de chirurgie cervico-faciale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Hôpital Edouard Herriot [CHU - HCL], Laboratoire de Biologie Tissulaire et d'ingénierie Thérapeutique UMR 5305 (LBTI), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), and Hôpital Henri Mondor
- Subjects
diagnosis ,[SDV.MHEP.OS] Life Sciences [q-bio]/Human health and pathology/Sensory Organs ,rhinomanometry ,nasal obstruction ,General Medicine ,[SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs - Abstract
International audience; Background: Internal valve collapse is a frequent cause of nasal obstruction but remains poorly understood and is sometimes treated inappropriately as a result. No functional or imaging test for the condition has been validated and the reference diagnostic technique is physical examination. The objective of this study was to evaluate the potential of four-phase rhinomanometry as a diagnostic test for internal valve collapse.Methods: In a case–control diagnostic accuracy study, the nostrils of adult patients consulting for chronic nasal obstruction were classified as “collapsed” or “non-collapsed” based on clinical findings. Four-phase rhinomanometry was performed in all patients. The area defined by the path of the flow/pressure curve in the two phases of inspiration (the “inspiratory loop area” or “hysteresis loop area”) was calculated for both nasal cavities and the threshold value with the highest Youden index was identified.Results: Sixty-six patients (132 nostrils) were included with 72 nostrils classified as collapsed and 60 as non-collapsed. Before nasal decongestion, the inspiratory loop area with the highest Youden index was 17.3 Pa L s−1 and the corresponding sensitivity and specificity were 88.3% (95% confidence interval, 80.0–95.0%) and 89.9% (82.6–95.7%), respectively.Conclusions: In these patients, a cutoff inspiratory loop area in four-phase rhinomanometry data reproduced clinical diagnoses of internal valve collapse with high sensitivity and specificity. This method may offer a firmer basis for treatment indications than subjective physical examinations.
- Published
- 2022