The effect of methodology on the determination of nasal resistance

Confusion and controversy continue to characterize scientific understanding of the role that respiration plays in modifying growth. Identification of specific methods to provide valid measurement of nasorespiratory function can help clinicians to (1) make an informed judgment regarding postulated relationships between respiration and growth, (2) test the validity of a diagnosis of impaired nasal respiration or "mouth breathing," and (3) evaluate the efficacy of treatment for nasal obstruction. A method that has been frequently used to quantify nasorespiratory function is nasal resistance measurement or rhinomanometry. This investigation used a common form of this method, studying 25 adult subjects to examine the effect of a number of variables in methodology on nasal airway resistance values. Results indicate that resistance to nasally inspired air was not significantly different from resistance to nasally expired air. However, a significant difference in estimating resistance was found between airflow rates of 0.25 and 0.5 L/sec, with nasal resistance increasing at the higher flow rate. Determination of the method error indicated that the technique was reliable and accurate for the sample studied. It was found that both expansion of the anterior nares and use of a nasal decongestant spray produced a decrease in mean nasal resistance. The study emphasizes the need to standardize the method of determining nasal resistance in order to permit comparisons among studies, to obtain a more reliable estimate of resistance, and to identify the location of maximum constriction in the nasal airway.