鼻部气道的气流感觉

为了观察正常人鼻部气流感觉与鼻通气度的关系，采用视觉类比标度法和前鼻测压法进行研究，发现鼻部对气流的主观感觉与实际鼻通气度即鼻气道阻力之间无明显相关性；并证实感觉鼻通气度的部位主要在鼻前庭。传统中药治疗鼻阻塞的挥发类药物（樟脑和薄荷）只能改善鼻通气的感觉，并不能改善鼻气道阻力。提示鼻部对气流的主观感觉不能完全反映实际的鼻通气程度。临床上诊断和治疗以鼻阻塞症状为主诉的患者时，应将患者鼻部对气流的主观感觉和测定鼻气道阻力结合起来，以对实际的鼻通气度和治疗效果作出客观评价。     

薄荷冰片和麝香对鼻气道阻力及鼻感觉的影响

祖医学常将薄荷，冰片作为改善鼻通气药以治疗鼻阻塞，但其作用机理尚不清楚。本实验在５２名受试者中研究了吸入薄荷冰、冰片、麝香对鼻气流阻力及鼻感觉的影响。结果发现这３种具有挥发性的药物都能够不同程度的引起鼻气道通畅的感觉，但对鼻气道阻力却无明显影响，因此作者认为此类药物可称为假性鼻通气药。     

薄荷冰片和麝香对鼻气道阻力及鼻感觉的影响

祖国医学常将薄荷、冰片作为改善鼻通气药以治疗鼻阻塞，但其作用机理尚不清楚。本实验在５２名受试者中研究了吸入薄荷冰、冰片、麝香对鼻气流阻力及鼻感觉的影响。结果发现这３种具有挥发性的药物都能够不同程度的引起鼻气道通畅的感觉，但对鼻气道阻力却无明显影响。因此作者认为此类药物可称为假性鼻通气药。     

内窥镜鼻窦手术前后鼻气道阻力的变化

目的研究内窥镜鼻窦手术对鼻气道阻力的影响及后者与鼻气流感觉的关系。方法利用前鼻测压法及视觉类比法对４２例（５０侧）慢性鼻窦炎鼻息肉患者手术前后、鼻减充血前后的鼻气道阻力和主观症状评分进行研究。结果术后鼻气道阻力明显下降,手术前后鼻气道阻力变化率喷麻黄素前后分别为（５５．７１±１３．９０）％和（２４．３２±８．７３）％,两者相比差异有显著性（Ｐ＜０．０５）;术前喷麻黄素前鼻气道阻力与主观鼻气流感觉显著相关（Ｐ＜０．０５,ｒ＝０．４２）。结论内窥镜鼻窦手术对鼻通气功能的改善主要是由于粘膜肿胀的消退而非鼻腔结构的改变;测定鼻气道阻力对于客观评价鼻通气功能仍具重要临床意义。     

鼻腔气流测定在鼻中隔偏曲矫正术中的应用

探讨鼻腔气流测定在鼻中隔偏曲矫正术中的应用价值。方法在鼻腔减充血状态下,采用前鼻测压法对２１例患者鼻中隔粘膜下切除术前后的双鼻腔阻力及气流进行测定并予比较。结果：发现双鼻腔气流差异率比鼻气道阻力更能反鼻通气功能,术前双鼻腔气流差异率绝对值大于５０％的患者后差,术后患者主观疗效评价与双鼻腔气流差异相关。     

鼻开放度主观感觉与单双侧鼻窦测压相关性评价

鼻测压法是目前应用最广泛的鼻通气量客观测定方法之一。本研究评价了鼻测压法与鼻阻塞自觉症状的关系。研究包括；（1）鼻阻塞患者200例，平均年龄36岁。先用可视类比刻度尺（visualauafogue。ale，VAS）评估其鼻阻塞程度，然后用鼻测压计测定阻力。（2）志愿者30名，经模拟4个等级不同程度鼻阻塞的管子呼吸，测定鼻阻塞阻力及在VAS上估价鼻阻的主观感觉程度。将鼻测压的数据按临床阻塞程度分为四级：过度开放、正常、阻塞、过度阻塞，病人鼻通气主观感觉在VAS上的程序也分为四级。鼻测压与VAS分级间符合程度用K系数来分析。结果表明…     

内窥镜鼻窦手术中不同中鼻甲处理方法对鼻气道阻力的影响

目的 :研究内窥镜鼻窦手术中不同中鼻甲处理方法对鼻气道阻力及主观鼻气流感觉的影响。方法 :采用主动前鼻测压法及视觉类比法对 32例 (侧 )中鼻甲完全切除患者、37例 (侧 )中鼻甲部分切除患者及 34例(侧 )中鼻甲完全保留患者内窥镜鼻窦手术前后鼻气道阻力和主观症状评分进行了研究。结果 :术后三组患者鼻气道阻力和主观症状评分均较术前明显下降 (P <0 .0 1) ,三组间鼻气道阻力及主观症状评分的差异均无显著性意义 (P >0 .0 5 )。结论 :中鼻甲不同处理方法对鼻气道阻力及主观鼻气流感觉无显著影响     

下鼻甲黏膜下骨质切除术联合骨折外移术对慢性肥厚性鼻炎治疗满意度及鼻通气功能的影响

目的 研究下鼻甲黏膜下骨质切除术联合骨折外移术对慢性肥厚性鼻炎（CHR）治疗满意度、鼻通气功能的影响。方法 选取我院62例CHR患者,随机分组,各31例,传统组给予传统下鼻甲部分切除术、给予联合组下鼻甲黏膜下骨质切除+骨折外移术。比较2组疗效、术前和术后6个月鼻通气主观感觉[视觉模拟量表（VAS）评分]、鼻通气功能[鼻腔最小横截面积至前鼻孔距离（DCAN）、鼻腔容积（NCV）、鼻腔最小横截面积（NMCA）、鼻气道阻力（NAR）]及治疗满意度。结果 总有效率、治疗满意度联合组较传统组高（P<0.05）;VAS术后联合组较传统组低（P<0.05）;与传统组比较,联合组术后6个月NCV、DCAN与NMCA较高,NAR较低（P<0.05）。结论 下鼻甲黏膜下骨质切除术联合骨折外移术治疗CHR疗效满意,可改善鼻通气功能,患者鼻通气主观感觉优良。     

鼻塞主客观评估的相关性

鼻塞的主观感觉与鼻道阻力 (NR)等客观参数之间的关系 ,所报道甚少 ,且结果多不一致。该文的主要目的是为了研究 :1鼻塞程度的主观感觉与前鼻压测定法所测得的 NR之间的相关性 ;2单侧鼻道阻力(UNR)与同侧对气流的主观感觉之间的相关性 ;3仅使用患者主观感觉评定鼻塞程度的价值。共挑选 158例 ,其中 75例无鼻部疾病主诉和病理改变 ,另 83例有鼻腔阻塞主诉。受测者鼻塞的主观感觉由图形量化值 (VAS)测定 ,UNR和全鼻道阻力(TNR)由前鼻压测定法测得 ,对整个样本 (n=158)以及对按有无鼻塞而分的 2组分别进行 TNR和 VAS的相关与回归分析 …     

下鼻甲等离子消融对变应性鼻炎患者鼻瓣区和主观鼻通气感觉的影响

目的 观察下鼻甲等离子消融术对变应性鼻炎患者鼻气道阻力(NAR)在鼻腔中分布和主观鼻通气感觉的影响.方法 采用主动性前鼻测压法,测定50例变应性鼻炎患者行下鼻甲消融手术前后NAR在鼻腔中分布以及主观鼻通气感觉评分情况.结果 正常人在鼻黏膜减充血前,内孔区NAR占全部NAR的15％,而梨状孔和下鼻甲前端则占37％,软骨段占67％,骨性鼻腔占33％.鼻黏膜减充血后,内孔区NAR明显加大,占32％,而梨状孔和下鼻甲前端减少至19％,骨性鼻腔则增大至45％.变应性鼻炎应用等离子行下鼻甲消融手术前,内孔区占15％,梨状孔和下鼻甲前端NAR占54％,软骨段占78％,骨性鼻腔占22％.下鼻甲消融术后,内孔区增加至37％,梨状孔和下鼻甲前端NAR减少至21％,软骨段减少至52％,骨性鼻腔增加至48％.术前主观鼻通气感觉评分为7.5±1.5,术后3个月为3.0±2.5,差异有统计学意义(P＜0.01).结论 下鼻甲等离子消融术可显著降低变应性鼻炎患者的NAR,同时可明显改善患者的主观鼻通气感觉.     

鼻阻塞的主观评价与客观鼻测量的相关性研究

目的 探讨鼻阻塞时检查者和患者的主观评价与客观鼻测量之间是否有相关性.方法 检查者和患者均采用视觉模拟量表(visual analog scale,VAS)对鼻阻塞程度进行评价.客观鼻测量采用主动后鼻测压仪和鼻声反射测量仪进行.以配对t检验分析检查者的临床评价和患者VAS均数的差异,以Spearman等级相关分析评价客观鼻测量结果单侧鼻气流阻力与单侧鼻道容积、单侧鼻腔最小横截面积的关系,以及检查者的临床评价、患者VAS与上述客观鼻测最结果的相关性.结果 本组病例经统计学分析,316例患者中,减充血前后单侧鼻气流阻力与单侧鼻道容积、单侧鼻腔最小横截面积间呈负相关(r值分别为-0.430、-0.554、-0.373、-0.600,P值均＜0.001).减充血前后,检查者的临床评价与患者VAS均数呈正相关,差异均有统计学意义(r值分别为0.630、0.526,P值均＜0.001),二者均与鼻气流阻力有一定的正相关关系(减充血前:检查者的临床评价与鼻气流阻力r=0.530,P=0.000,患者VAS与鼻气流阻力r=0.351,P=0.000;减充血后:检查者的临床评价与鼻气流阻力r=0.452,P=0.000,患者VAS与鼻气流阻力r=0.216,P=0.000),与鼻道容积和鼻腔最小横截面积均有一定的负相关关系(减充血前:检查者的临床评价与鼻道容积r=-0.411,P=0.000,患者VAS与鼻道容积r=-0.325,P=0.000,检查者的临床评价与鼻腔最小横截面积r=-0.507,P=0.000,患者VAS与鼻腔最小横截面积r=-0.384,P=0.000;减充血后:检查者的临床评价与鼻道容积r=-0.391,P=0.000,患者VAS与鼻道容积r=-0.209,P=0.000,检查者的临床评价与鼻腔最小横截面积r=-0.471,P=0.000,患者VAS与鼻腔最小横截面积r=-0.286,P=0.000).检查者的临床评价与客观鼻测量参数的相关系数大于患者VAS与客观鼻测最参数的相关系数.结论 鼻阻力测压与鼻声反射测量的结果有一定的相关性.检查者的临床评价与患者VAS存在一定的正相关关系.两者均与客观鼻测量参数存在一定的直线相关关系.     

The effects of D and L isomers of menthol upon nasal sensation of airflow

Objective and subjective measurements of nasal airflow were made before and after inhalation of Vanilla, D-Menthol and L-Menthol separately. Despite the fact that the menthol isomers were mirror images of one another, only L-Menthol produced the sensation of increased nasal airway patency. No objective change in resistance was found after inhaling either D-Menthol, L-Menthol or the vanilla control. These findings demonstrate that L-Menthol exerts a specific action upon nasal sensory nerve endings, which are responsible for the subjective appreciation of nasal airflow.     

Experimental studies on nasal sensation of airflow

Objective and subjective measurements of nasal airflow were made before and after inhalation of vanilla and a commercial mixture of aromatics used to treat nasal stuffiness. These substances had no effect on nasal resistance to airflow but caused significant changes in the subjective sensation of nasal airflow. The use of a visual numerical scale for the assessment of nasal sensation of airflow is discussed in terms of its significance as regards quantifying changes in nasal sensation of airflow before and after nasal surgery.     

Experimental studies on nasal sensation of airflow

Objective and subjective measurements of nasal airflow were made before and after inhalation of vanilla and a commercial mixture of aromatics used to treat nasal stuffiness. These substances had no effect on nasal resistance to airflow but caused significant changes in the subjective sensation of nasal airflow. The use of a visual numerical scale for the assessment of nasal sensation of airflow is discussed in terms of its significance as regards quantifying changes in nasal sensation of airflow before and after nasal surgery.     

The effect of nasal mucosal vasoconstriction on nasal airflow sensation

The correlation between the objective measurement of nasal resistance and nasal airflow sensation is usually regarded as poor. To investigate the relationship between these two parameters 20 healthy volunteers had nasal resistance to airflow measured by rhinomanometry compared with nasal sensation by visual analogue scoring before and after nasal mucosal vasoconstriction using topical 0.1% xylometazoline. The median change in nasal resistance was 0.2 kPal^-1s (95% CI 0.08–0.28 kPal^-1s) and in nasal sensation 24 mm (95% CI 17 mm-35 mm). A significant relationship between nasal sensation and nasal resistance to airflow was found (Kendall's Rank correlation (P < 0.05). This function can be described by the linear regression equation: dS = 13.2 + 70.dNR where dS = change in nasal sensation and dNR = change in nasal resistance. There may be a much closer relationship between subjective and objective measures of nasal patency than has previously been thought.     

The effect of lignocaine on nasal resistance and nasal sensation of airflow

The effect of lignocaine on nasal sensation of airflow and nasal resistance was assessed in twenty-five subjects. A randomised crossover trial was conducted with lignocaine as the active drug and saline as the placebo. Both substances were delivered to the nasal mucosa as a nasal spray. Lignocaine caused a sensation of increased nasal patency in twenty-two of the twenty-five subjects studied. Saline had no such effect. The difference between this subjective effect of the two substances was highly significant (p less than 0.001). Neither spray had any significant effect on nasal resistance to airflow assessed objectively by rhinomanometry.     

内窥镜鼻窦手术前后鼻气道阻力的变化

OBJECTIVE: To study the influence of endoscopic sinus surgery(ESS) on nasal airway resistance (NAR) and to analyze the relationship between NAR and nasal airflow sensation. METHODS: The NAR and nasal airflow sensation were measured with anterior rhinomanometry and visual analogous scale test (VAS) in 42 patients (50 sides) before and after the ESS. RESULTS: NAR decreased significantly after the operation. The change rates in NAR before and after the decongestion were (55.71 +/- 13.90)% and (24.32 +/- 8.73)%, respectively, and there was a significant difference (P < 0.05). The pathological increase in NAR correlated well with subjective sensation of the patients (P < 0.05). CONCLUSION: The improvement of nasal functions by ESS is not due to the alteration of the anatomic structure of the nasal cavity, but to the amelioration of mucosal edema. The rhinomanometry can be used as a useful clinical tool in determining nasal patency.     

Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence

Background: There is no consensus about the value of objective measurements of nasal patency. Objective: To assess the correlation between the subjective sense of nasal patency and the outcomes found with rhinomanometry and acoustic rhinometry. Type of review: Structured literature search. Search strategy and evaluation method: Review of English‐language articles in which correlations were sought between subjective nasal patency symptoms and objective scores as found with rhinomanometry [nasal airway resistance (NAR)] and acoustic rhinometry [minimal cross‐sectional area (MCA)]. Correlations were related to unilateral or combined assessment of nasal passages and to symptomatic nasal obstruction or unobstructed nasal breathing. Results: Sixteen studies with a level of evidence II‐a or II‐b fit the inclusion criteria and were further analysed. Almost every possible combination of correlations or lack thereof in relation to the variables included was found. However, when obstructive symptoms were present, a correlation between the patency symptoms with nasal airway resistance and minimal crosssectional area was found more often than in the absence of symptoms. In cases of bilateral assessment a correlation was found almost as often as it was not between patency symptoms and total nasal airway resistance or combined minimal crosssectional areas, while in the limited amount of studies in which unilateral assessment was done a correlation was found each time between patency symptoms and nasal airway resistance. Conclusions: The correlation between the outcomes found with rhinomanometry and acoustic rhinometry and an individual’s subjective sensation of nasal patency remains uncertain. Based on this review, it seems that the chance of a correlation is greater when each nasal passage is assessed individually and when obstructive symptoms are present. There still seems to be only a limited argument for the use of rhinomanometry or acoustic rhinometry in routine rhinologic practice or for quantifying surgical results. Clin. Otolaryngol. 2009, 34 , 518–525.