Current value of nasal nitric oxide measurement in rhinology

Since the first description of nitric oxide in the exhaled breath of humans by Gustafsson et al., there has been enormous interest in the study of nitric oxide and its role in the nose and paranasal sinuses. The aim of this review is to present the current knowledge about nasal NO: its physiology, novel methods of detection and measurement, and implications in sinonasal disease, focusing on the recent data from the literature.

Nitric oxide production is known to be produced in the nose at the apical tip of the ciliated respiratory mucosa. A new study has localized nitric oxide production in the pericytes and osteocytes of nasal turbinates. Studies have also discovered the efficacy of offline measurement techniques showing high correlation between standard online measurements with offline techniques. In an interesting study examining the influence of maxillary ostium size and nasal nitric oxide levels, decreased nitric oxide levels found with larger size ostia may eventually influence our approach to sinus surgery.

Nasal nitric oxide has been an ever-increasing topic of interest to both the allergist and the head and neck surgeon. The recent advances in the study of nasal nitric oxide as it relates to sinonasal disease and nasal physiology are discussed and important new findings are highlighted.