Post-Exercise Nasal Patency, Spirometry, and CBCT-Derived Lund-Mackay Scores in Competitive Swimmers: A Multivariate...

Area of Science:

• Sports Medicine
• Respiratory Physiology
• Otolaryngology

Background:

• Competitive swimmers exhibit supranormal lung function alongside a high incidence of upper-airway structural issues.
• The interplay between sinonasal health and respiratory function in athletes remains an area of active investigation.

Purpose of the Study:

• To investigate the relationship between computed tomography (CT)-quantified sinus mucosal burden and post-exercise peak nasal inspiratory flow (PNIF) in competitive swimmers.
• To determine if combining these measures with spirometry can identify distinct ventilatory subgroups within this athletic population.

Main Methods:

• Twenty-nine competitive swimmers underwent nasal endoscopy, CT scans with Lund-Mackay (LM) scoring, bilateral PNIF measurements (rest and post-exercise), and spirometry.
• Principal component analysis (PCA) and hierarchical cluster analysis were used to analyze data including changes in PNIF (ΔPNIF), LM score, resting spirometry, and maximal tethered sprint force (Fmax).

Main Results:

• No significant correlation was found between sinus mucosal burden (LM score) and the change in PNIF (ΔPNIF).
• Clustering did not reveal a subgroup characterized by reduced PNIF and elevated LM score; the subgroup with the highest LM score paradoxically showed the greatest ΔPNIF.
• Resting spirometry remained supranormal across all subgroups, and exercise-induced bronchodilation was pronounced. Maximal tethered force (Fmax) was the only significant correlate of competitive performance.

Conclusions:

• Sinus mucosal burden and post-exercise nasal decongestion are not significantly associated in this cohort of competitive swimmers.
• The study did not identify a distinct "dysfunctional" ventilatory-sinonasal phenotype using the combined measures.
• Post-exercise PNIF and resting spirometry appear to reflect independent physiological aspects, and neither, alone or combined with CT findings, identified a specific clinical subgroup relevant to performance in this sample.