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Clinical parameters influencing the results of anterior rhinomanometry in children
Hans J Welkoborsky1,2, Christina Rose-Diekmann3,4, Anja Pähler Vor der Holte3,4
1Department of Otorhinolaryngology, Head and Neck Surgery, Nordstadt-Clinic, Academic Hospital, Haltenhoffstr. 41, 30167, Hannover, Germany. welkohno.hanno@t-online.de.
Insights
Rhinomanometry can objectively assess pediatric nasal obstruction, with results correlating with height, age, and adenoidectomy status. This method is reliable for individual allergy testing in children, despite age-specific variations.
Area of Science:
- Otorhinolaryngology
- Pediatric Medicine
- Allergy Diagnostics
Background:
- Nasal obstruction is a common pediatric symptom requiring otorhinolaryngologist consultation.
- Anterior rhinomanometry and endoscopy are gold standards for assessing nasal obstruction severity.
- Limited data exist on rhinomanometry in children, necessitating further evaluation.
Purpose of the Study:
- To evaluate the application of anterior rhinomanometry for objective nasal flow assessment in children.
- To determine the reproducibility of rhinomanometry in the pediatric population.
- To identify clinical parameters influencing rhinomanometry results in children.
Main Methods:
- 427 children (7 months–17 years) underwent clinical examination, endoscopy, and anterior rhinomanometry.
- Nasal flow was measured before and after decongestant drops at 150 Pasc.
- Flow values were correlated with age, height, endoscopic findings, and allergy prick tests.
Main Results:
- Reproducible measurements were achieved in children aged 3 years and older, with significant variations.
- Nasal flow showed significant positive correlations with body height and age (p<0.01).
- Post-adenoidectomy status correlated with nasal flow (p<0.05); no correlation with allergy tests was found.
Conclusions:
- Rhinomanometry is applicable for objective pediatric nasal obstruction evaluation and assessing decongestant effects.
- Nasal flow correlates most strongly with height, age, and adenoidectomy status.
- While challenging to define normal values due to variability, rhinomanometry is reliable for individual pediatric allergy testing.
Background:
Nasal obstruction is a frequent symptom in both adults and children and it is a common reason to see an otorhinolaryngologist. Endoscopy of the nasal cavity and the epipharyngeal space along with anterior rhinomanometry is regarded the gold standard since many years to estimate the severity of nasal obstruction in the particular patient. Endoscopy shows anatomical reasons for an obstruction, whereas the nasal flow volume and nasal resistance can be determined using anterior rhinomanometry. Currently, there are only few data available for rhinomanometry results in children. The purpose of the present study was to evaluate the application of this technique in the pediatric population for objective evaluation of nasal flow. Whether it achieves reproducible results and which clinical parameters have some influence on the results were studied.
Patients And Methods:
427 children (average age of 8.5 years, range 7 months through 17 years) who were admitted to evaluate nasal patency or for allergy testing were examined. After clinical examination and endoscopy of the nasal cavity and epipharyngeal space, anterior rhinomanometry was performed before and after application of decongestant nose drops separately for each nose side in 334 children. The nasal flow with a pressure of 150 Pasc was measured and served for statistical evaluation. Flow values were correlated to clinical and endoscopic parameters along with results of allergy tests (prick tests).
Results:
Reproducible rhinomanometric measurements were possible in children age 3 years and older. However, the standard deviation and variation of measurements were significant in this cohort of patients. Statistically highest significant correlations were found between flow measurements and body height along with the age of the children (p < 0.01) and status following adenoidectomy (p < 0.05). No statistically significant correlations were found between rhinomanometry and results of prick tests.
Conclusions:
The study demonstrates that rhinomanometry can be applied in the pediatric population for objective evaluation of nasal obstruction and for determining the effects of decongestant nose drops. The highest correlation was found between nasal flow and children's body height, children's age and status following adenoidectomy. The correlation between nasal flow and clinically/endoscopically determined degree of nasal obstruction was lower. However, definition of normal flow values for particular age groups is challenging since the results showed high variation and standard deviation. Yet with regard to individual patient, the technique achieves reliable results in nasal provocation tests, which are widely used for allergy testing in children. When performed in children it should always be considered that there are age-specific requirements for the examination and interpretation of results in this patient cohort.
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