Endoscopic assessment validated method of the internal nasal valve area
S.A. Karpishchenko1,2, A.A. Zubareva1, E.V. Bolozneva1, S.V. Baranskaya1, A.F. Fatalieva1
1I.P. Pavlov First Saint Petersburg State Medical University
2Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Aim: to validate the endoscopic assessment method of the internal nasal valve (INV) area.
Patients and Methods: the study was conducted at the Clinic of Otorhinolaryngology (I.P. Pavlov First Saint Petersburg State Medical University). 32 patients underwent the study (men — 14, women — 18, age ranged from 21 to 44 years), which were divided into two groups. Group 1 consisted of patients (n=16) with INV insufficiency, and group 2 included healthy patients (n=16) — the control group. Each patient underwent cone-beam computed tomography of the paranasal sinuses and endoscopic examination of the nasal cavity according to the proposed method. The obtained endoscopic pictures analysis was processed in the designed program for the INV area and angle calculation. CT scans also measured the INV area and angle.
Results: ANOVA showed the following measurements in the INV angles of each nasal cavity half by the endoscopic method in group 1: the right half of the nasal cavity (RHNC) 7±3,1°; the left half of the nasal cavity (LHNC) 8±2° and in the group 2 (RHNC 18±3°; LHNC 16±2°), statistically differed from the CT data on angles in group 1 (RHNC 5±2°; LHNC 6±1,5°) and in group 2 (RHNC 12±4°; LHNC 11±2.2°) (p<0.05). However, the INV area determined by endoscopic method and measured by CT did not differ significantly (p>0.05) in the group of examined patients. Comparison of the INV angle and cross-sectional area between the groups of examined patients showed a significant difference in the measurement parameters (p<0.05).
Conclusion: obtained data indicate the association of the used methods. Thus, endoscopic assessment method, as well as computed tomography, comparatively reliably determines the INV area. However, the INV angle is most accurately estimated on coronary CT sections.
Keywords: internal nasal valve, endoscopic method, computed tomography.
For citation: Karpishchenko S.A., Zubareva A.A., Bolozneva E.V. et al. Endoscopic assessment validated method of the internal nasal valve area. RMJ. Medical Review. 2019;9(II):63–68.
2. Пискунов Г.З. Физиологическое и патофизиологическое обоснование функциональной риносинусохирургии. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2018;1;23–28. [Piskunov G.Z. Physiological and pathophysiological basis for functional endoscopic sinus surgery. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2018;1:23–28 (in Russ.)].
3. Graviero G. The role of three-dimensional CT in the evaluation of nasal structures and anomalies. European Archives of Oto-Rhino-Laryngology. 2011:268:1163–1167. DOI: 10.1007/s00405-011-1575-1.
4. Соболев В.П., Спиранская О.А., Махамбетова Э.А. Эпидемиологические аспекты патологии носового клапана. РМЖ. 2016;4;254–256. [Sobolev V.P., Spiranskaya O.A., Makhambetova E.A. Epidemiology of nasal valve pathology. RMJ. 2016;4:254–256 (in Russ.)].
5. Becker D.G. Surgical treatment of nasal obstruction in rhinoplasty. Aesthetic surgery journal. 2010;3:347–378. DOI: 10.1177/1090820X10373357.
6. Lee J., White W.M., Constantinides M. Surgical and nonsurgical treatments of the nasal valves. Otolaryngologic Clinics of North America. 2009;3:495–511. DOI:10.1016/j.otc.2009.03.010.
7. Cem Miman M. Internal nasal valve: revisited with objective facts. Otolaryngology — Head and Neck Surgery. 2006;1:41–47. DOI:10.1016/j.otohns.2005.08.027.
8. Stewart M.G., Smith T.L. Objective versus subjective outcomes assessment in rhinology. American journal of rhinology. 2005;5:529–535. DOI: 10.1177/194589240501900518.
9. Montgomery W.M. Computed tomography: a three-dimensional study of the nasal airway. Journal of Computer Assisted Tomography. 1980;4:573.
10. Kassel E.E., Cooper P.W., Kassel R.N. CT of the nasal cavity. J Otolaryngol. 1983;1:16–36.
11. Çakmak Ö., Coşkun M., Celik H. et al. Value of acoustic rhinometry for measuring nasal valve area. The Laryngoscope. 2003;2:295–302. DOI: 10.1097/00005537-200302000-00018.
12. Naito K., Cole P., Chaban R., Oprysk D. Nasal resistance, sensation of obstruction, and rhinoscopic findings compared. Am J Rhinol. 1988;2:65–69.
13. Bloom J.D., Sridharan S., Hagiwara M. et al. Reformatted computed tomography to assess the internal nasal valve and association with physical examination. Arch Facial Plast Surg. 2012;5:331–335. DOI: 10.1001/archfaci.6.4.240.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
