Physiology: Rhinomanometry
Rhinomanometry is the simultaneous measurement of airflow through the nose and pressure across the nose during breathing. Figure 25.1 shows plots of transnasal pressure and flow during respiration. As the patient inspires, the curves go downward showing a
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John Pallanch
Keywords
Rhinomanometry • Nasal obstruction • Airway resistance • Nasal airway obstruction • Nasal cavity • Nasal blockage • Nasal provocation tests
Core Messages
1. Rhinomanometry allows objective assessment of nasal resistance, the ratio of transnasal pressure over transnasal airflow measured during nasal respiration. 2. Many aspects of the study of nasal physiology have been studied with the aid of rhinomanometry. 3. Rhinomanometry assesses the overall effect of nasal airway dimension and shape on the passage of air through the nose.
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the corresponding movement of air in the direction of the lungs. As the patient changes to expiration, the curves move upward, corresponding to pressure increasing and causing the movement of air out of the nose. Dividing the maximum pressure reached during normal inspiration by the highest flow gives a nasal resistance value that correlates with the symptom of nasal obstruction in symptomatic patients. This objective test has been crucial in increasing understanding in many areas of nasal physiology. While the extent of its use varies in different parts of the world, it is still used in research and in clinical assessment of nasal function.
Introduction
Rhinomanometry is the simultaneous measurement of airflow through the nose and pressure across the nose during breathing. Figure 25.1 shows plots of transnasal pressure and flow during respiration. As the patient inspires, the curves go downward showing a decrease in pressure and J. Pallanch, MD, MS, FACS Department of Otorhinolaryngology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA e-mail: [email protected]
Resistance calculated at the maximum pressure and flow correlates with the symptom of nasal obstruction.
This chapter will provide a framework to put the role of rhinomanometry in context among the other tools used to objectively assess nasal function. The methods of rhinomanometry will be described. The research role that rhinomanometry has played in discoveries in nasal physiology will be covered including the nasal cycle, changes
T.M. Önerci (ed.), Nasal Physiology and Pathophysiology of Nasal Disorders, DOI 10.1007/978-3-642-37250-6_25, © Springer-Verlag Berlin Heidelberg 2013
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Pressure
Expiration ΔP
Flow
Inspiration
• V
Expiration Inspiration
Fig. 25.1 Shows a plot of pressure and flow during respiration. As the patient inspires, the curves go downward showing a decrease in pressure and the corresponding movement of air in the direction of the lungs. As the patient changes to expiration, the curves move upward corresponding pressure increasing and the movement of air out of the nose
with growth, posture, and exercise; changes to the downside of the nose when a patient is lying down; and resistance in the normal nose and the nose with disturbed breathing function. The chapter ends with a summary of the clinical applications for which rhinomanometry has been used.
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The Context of Rhinomanometry in Assessing Nasal Respiratory Function
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