Influence of sinus surgery in rhinometric measurements

The objectives of this prospective study were to clarify how well acoustic rhinometry (AR), computed tomography volumetry (CTV), rhinomanometry (RMM), and the visual analogue scale (VAS) identify changes in intranasal pathology after endoscopic sinus surgery in patients with chronic sinusitis. The measurements were performed in 44 nasal cavities of 11 patients pre- and postoperatively, 6 of whom underwent middle meatal antrostomy and 5 of whom underwent ethmoidectomy. The AR and RMM results were compared with those obtained with CTV and VAS. Furthermore, a favourable outcome in sinus surgery was obtained with all of the methods. The results showed clearly that endoscopic sinus surgery significantly changes the intranasal geometry and can be obtained reliably using rhinometric measurements. Both AR and CTV identified statistically significant (p < .05) volume changes in the nasal cavities. The AR and CTV results correlated generally well (r = .72) with each other, but wide differences were seen between the operative groups. Correlation in the ethmoidectomy group was very strong (r = .93) but weak in the middle meatal antrostomy group (r = .37). In the nasal function measurements, nasal obstruction decreased significantly (p < .05) after the surgery. The changes were clearly obtained using RMM and VAS (p < .05). Correlation between these methods was generally poor (r < .30), but a difference was again seen in the operative groups. In the ethmoidectomy group, correlation was moderately good (r = .55) but weak in the middle meatal antrostomy group (r = .29). We concluded that rhinometric methods are reliable tools for evaluation of operative outcome in endoscopic sinus surgery patients. Inspiratory resistance measured with RMM and nasal obstruction assessed with VAS appeared to measure separate parameters in nasal function.