Experimental studies of the resolution of acoustic rhinometry in vivo

The ability of acoustic rhinometry to detect objects of defined size in nasal cavities has hitherto been investigated only in cadavers and models. We aimed to determine the resolution of the technique in the nose of living subjects. Silicone spheres of 3.0, 5.0, and 7.0 mm diameter were placed at two sites in the decongested and locally anaesthetised nasal cavities of 3 healthy adults. Acoustic rhinometry area-distance functions were obtained before and after insertion of the spheres, with further control data obtained after removal of the sphere from the nasal cavity. Six nasal cavities were studied in each test state on two separate occasions. The 3.0 mm sphere caused a statistically significant change in cavity volumes in only 17% of cases when placed in the middle meatus and in 8% at the nasal value (Mann-Whitney U-test; p < 0.05). The detection rates for the 5.0 mm sphere were 50% in the middle meatus and 50% at the nasal valve. When the control and test curves were compared by superimposition and the cross-sectional areas at the site of perturbations compared statistically (Mann-Whitney U-test) the detection rates in the middle meatus were: 33%-3.0 mm and 67%-5.0 mm sphere. The detection rate at the nasal valve region was 25%-3.0 mm sphere and 58%-5.0 mm. The 7.0 mm sphere was detected in 100% cases by volume changes, and 80% by area changes. Acoustic rhinometry can reliably detect changes of volume and area in the living nose resulting from the introduction of a 7 mm sphere into the nasal valve or middle meatal region in most cases. Smaller spheres are detected in only a fraction of cases. The resolution of the technique is therefore close to 7.0 mm (1.44 cm3). These findings are important when interpreting acoustic rhinometry data in monitoring patients with nasal pathology.