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Ottaviano G. Nasal Patency Measurement: State of the Art of Acoustic Rhinometry. Facial Plast Surg 2024; 40:304-309. [PMID: 38016661 DOI: 10.1055/a-2218-7297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
Nasal obstruction is one of the main symptoms of different nasal pathologies. Many physiological and pathological conditions can produce nasal airflow impairment causing nasal obstruction and affecting patients' quality of life. There are different methods for the measurement of nasal obstruction, but in clinical practice the most common used are acoustic rhinometry, rhinomanometry, and peak nasal inspiratory flow. This review describes the fundamentals of acoustic rhinometry, its normal values, the different physiological and pathological conditions that can modify nasal patency, and the utility of this instrument for the measurement of nasal obstruction in clinical practice. Acoustic rhinometry is a simple test, so it is suitable for measurements in the pediatric population, i.e., for evaluating adenoid hypertrophy. Acoustic rhinometry normal values are available, unilaterally and bilaterally for pediatric and adult populations. Acoustic rhinometry has been demonstrated to be reproducible and even superior to rhinomanometry when measuring nasal modifications during challenges. It is possible to use acoustic rhinometry before and after nasal surgery. Measuring nasal cavities volume and cross-sectional area, acoustic rhinometry is particularly indicated in rhinosurgery, especially for the evaluation of spreader grafts. Brief considerations about the correlation between nasal symptoms, in particular the subjective sensation of nasal obstruction, and the acoustic rhinometry results as well as the correlation of acoustic rhinometry with other methods for the measurement of nasal obstruction are also reported. Objective and subjective evaluation of nasal obstruction gives different information that together optimizes the diagnosis and the treatment of rhinologic patients. Acoustic rhinometry alone or in combination of other instruments for the measurement of nasal obstruction or patency should be used regularly in every outpatient clinic that treats patients with nasal obstruction as there is an increasing need of evidence-based therapies.
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Affiliation(s)
- Giancarlo Ottaviano
- Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy
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Oka S, Kawanabe H, Yamanobe S, Fukui K, Baba Y, Deguchi T. Relationship between olfaction and maxillofacial morphology in children with malocclusion. Clin Exp Dent Res 2020; 7:33-39. [PMID: 32977366 PMCID: PMC7853900 DOI: 10.1002/cre2.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 07/29/2020] [Accepted: 08/21/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Functional problems, including nasal flow problems, are associated with specific skeletal and dental features. Further, maxillary expansion has been associated with nasal airway resistance alterations. This study aimed to investigate whether there is a correlation between skeletal features and nasal airflow- and olfaction-related problems. MATERIALS AND METHODS This prospective study included 68 patients (30 boys, 38 girls; mean age 9 ± 2 years) examined at the Ohu University Hospital. We classified patients into three skeletal Classes (Class I, II, and III) based on the ANB angle. Olfactory disorder history was collected from the guardians. Maxillofacial measurements, nasal airflow assessments, and olfactory tests were performed using cephalometric analysis, rhinomanometry, and T&T olfactometer, respectively. RESULTS Malocclusion, resulting from skeletal mandibular protrusion and smaller maxilla, was associated with reduced olfaction in children. The detection and recognition thresholds of skeletal Class III were significantly higher than those of Classes I (p = .01) and II (p = .01). Significant correlations were observed between SNA and the detection threshold (r = -.50) as well as between nasion perpendicular-point A and the recognition threshold (r = -.53). The detection and recognition thresholds were significantly higher in Class III than in Classes I (r = .3) and II (r = -.1). CONCLUSIONS Maxillary growth and development may be associated with olfaction in children. Changing the maxillofacial morphology may improve olfactory function. In the future, we will investigate how malocclusion treatment affects olfactory function.
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Affiliation(s)
- Shiori Oka
- Department of Oral Growth and Development, Division of Dentofacial Orthopedics, Ohu University, Graduate School of Dentistry, Fukushima, Japan
| | - Hitoshi Kawanabe
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University, School of Dentistry, Fukushima, Japan
| | - Shinya Yamanobe
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University, School of Dentistry, Fukushima, Japan
| | - Kazunori Fukui
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University, School of Dentistry, Fukushima, Japan
| | - Yuh Baba
- Department of General Clinical Medicine, Ohu University, School of Dentistry, Fukushima, Japan
| | - Toru Deguchi
- Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Calvo-Henriquez C, Capasso R, Chiesa-Estomba C, Liu SY, Martins-Neves S, Castedo E, O'Connor-Reina C, Ruano-Ravina A, Kahn S. The role of pediatric maxillary expansion on nasal breathing. A systematic review and metanalysis. Int J Pediatr Otorhinolaryngol 2020; 135:110139. [PMID: 32502910 DOI: 10.1016/j.ijporl.2020.110139] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE A reduced transversal dimension of the maxilla leads to narrower nasal cavities, which may reduce airflow to the lungs. Maxillary expansion widens nasal floor. However, there is huge controversy regarding whether this increase does actually lead to increased airflow. In this systematic review and meta-analysis we aim to resolve this question by evaluating studies that have undertaken rhinomanometric measurements. REVIEW METHODS Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors. Two authors extracted the data. Main outcome was expressed as the difference between resistance before and after treatment and the 95% confidence interval. RESULTS 30 studies were selected for full text reading. A total of 12 studies (301 patients) met the inclusion criteria. All selected articles found reduced resistance after palatal expansion. The data pooled in the meta-analysis reveals a statistically significant difference of 0.12 Pa s/cm3 mean reduction after palatal expansion (CI 95% 0.06, 0.18) for nine uncontrolled studies. Regarding nasal airflow, the pooled data show a statistically significant difference of 29.9 cm3/s increase after palatal expansion (CI 95% 9.17, 50.64). CONCLUSION According to the available evidence, palatal expansion in pediatric patients decreases nasal resistance and increases nasal flow.
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Affiliation(s)
- Christian Calvo-Henriquez
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain.
| | - Robson Capasso
- Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
| | - Carlos Chiesa-Estomba
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - Stanley Yung Liu
- Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
| | | | - Elena Castedo
- Orthodontic Private Practice, Santiago de Compostela, Spain
| | | | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain
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Ottaviano G, Maculan P, Borghetto G, Favero V, Galletti B, Savietto E, Scarpa B, Martini A, Stellini E, De Filippis C, Favero L. Nasal function before and after rapid maxillary expansion in children: A randomized, prospective, controlled study. Int J Pediatr Otorhinolaryngol 2018; 115:133-138. [PMID: 30368373 DOI: 10.1016/j.ijporl.2018.09.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Children can well detect and respond to odours in order to have information about food and environment. Rapid Maxillary Expansion seems to improve dental and skeletal crossbite and increase nasal patency correcting oral respiration in children. A previous pilot study suggested that Rapid Maxillary Expansion may lead to improved N-Butanol olfactory thresholds, and peak nasal inspiratory flow values (PNIF). The aim of the present study was to prospectively evaluate olfactory threshold, nasal flows and nasal resistances in children aged from 6 to 11 years before and after Rapid Maxillary Expansion, comparing treated children with a control group of similar age, growth stage (prepubertal) and transversal skeletal deficiency. METHODS N-butanol olfactory thresholds, anterior active rhinomanometry (AAR) and PNIF were measured in 11 children (6-11 years) before (T0), immediately and 6 months after Rapid Maxillary Expansion application (T1 and T2 respectively), and in a control group of 11 children (6-11 years) whose members remained under observation for the period of the study. RESULTS Considering the study group, PNIF values improved at T1 respect to the T0 values (p = 0.003), while T2 values were significantly higher than T0 ones (p = 0.0002). N-Butanol Olfactory Threshold significantly improved at each control (p = 0.01, p = 0,01 and p = 0.0003, for T1 vs T0, T2 vs T1, T2 vs T0 respectively). No differences on AAR values were found during the six months follow-up in this group. Considering the control group, no significant differences were found for any of the considered variables during the time of the study. Comparing the two groups, there was a significant increase of PNIF values in the study group compared to the control group (p = 0.003) at T1, which was even more evident six months after Rapid Maxillary Expansion (p = 0.0005). This improvement was not shown by AAR values. N-Butanol Olfactory Threshold showed a significant improvement at T2 respect to T1 (p = 0.002) and T0 (p = 0.0005). CONCLUSION Rapid Maxillary Expansion seems to significantly improve the respiratory capacity of treated patients, at least in terms of PNIF, and their olfactory function, measured by N-Butanol Olfactory Threshold Test. Further studies should be performed to evaluate if also changes in nasal resistances, measured by AAR, could occur, maybe considering a larger group of subjects and possibly using 4-phase rhinomanometry in order to evaluate the effective resistances during the entire breath.
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Affiliation(s)
- G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University of Padova, Padova, Italy.
| | - P Maculan
- Department of Neurosciences DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - G Borghetto
- Department of Neurosciences DNS, Odontostomatology Institute, University of Padova, Padova, Italy
| | - V Favero
- Department of Surgery, Dentistry and Maxillofacial Unit, University of Verona, Verona, Italy
| | - B Galletti
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - E Savietto
- Department of Neurosciences DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - B Scarpa
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - A Martini
- Department of Neurosciences DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - E Stellini
- Department of Neurosciences DNS, Odontostomatology Institute, University of Padova, Padova, Italy
| | - C De Filippis
- Department of Neuroscience, University of Padova, Audiology Unit at Treviso Hospital, Treviso, Italy
| | - L Favero
- Department of Neurosciences DNS, Odontostomatology Institute, University of Padova, Padova, Italy
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Schriever VA, Gellrich J, von der Hagen M, Hummel T. Acquired Olfactory Dysfunction in Children and Adolescents: A Systematic Review of the Literature. Chem Senses 2018; 43:571-581. [DOI: 10.1093/chemse/bjy046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Valentin A Schriever
- Abteilung Neuropädiatrie an der Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse, Dresden, Germany
| | - Janine Gellrich
- Abteilung Neuropädiatrie an der Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse, Dresden, Germany
| | - Maja von der Hagen
- Abteilung Neuropädiatrie an der Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Technische Universität Dresden, Fetscherstrasse, Dresden, Germany
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Ottaviano G, Ermolao A, Nardello E, Muci F, Favero V, Zaccaria M, Favero L. Breathing parameters associated to two different external nasal dilator strips in endurance athletes. Auris Nasus Larynx 2017; 44:713-718. [DOI: 10.1016/j.anl.2017.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 01/03/2017] [Accepted: 01/11/2017] [Indexed: 11/24/2022]
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Ottaviano G, Marioni G, Frasson G, Zuccarello D, Marchese-Ragona R, Staffieri C, Nardello E, Frigo AC, Foresta C, Staffieri A. Olfactory threshold for bourgeonal and sexual desire in young adult males. Med Hypotheses 2015; 84:437-41. [PMID: 25665864 DOI: 10.1016/j.mehy.2015.01.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/13/2015] [Accepted: 01/23/2015] [Indexed: 01/06/2023]
Abstract
Olfactory receptors were found to be expressed also in human sperm giving rise to the hypothesis that they might play a role in fertility and sexual behavior. For instance, bourgeonal was demonstrated to be an agonist of sperm cells olfactory receptor, OR1D2. OR1D2 has been found to be expressed in human olfactory epithelium and to play a critical role in human sperm chemotaxis. Recent preliminary evidence showed that olfaction sensitivity (determined by n-butanol olfactory threshold) and sexual desire were associated in young adult males. It is reasonable to hypothesize that bourgeonal olfactory threshold could be related with human sexual behavior and desire. In 37 healthy young adult male volunteers (age range 20-36 years), the bourgeonal odor threshold and the intensity of sexual desire [the latter using the International Index of Erectile Function (IIEF) scale] were examined. In addition, samples of DNA were collected. Allele and genotype frequency of the OR1D2 single nucleotide polymorphisms (SNPs) were then evaluated in order to study the relationship between sexual desire and OR1D2 SNPs expression. The olfactory threshold was categorized as <10, 10⩽threshold<15, 15⩽threshold<20, ⩾20. IIEF 1 and IIEF 2 scores were significantly associated. IIEF1 scores, but not IIEF2 scores were significantly associated with olfactory threshold. No statistically significant associations were found neither between genotypes frequency and sexual desire (IIEF1 and IIEF2), nor between genotypes frequency and olfactory threshold. Hypothesizing for the first time the relationship between bourgeonal olfactory sensitivity and sexual desire in a group of young adult males, the present study found a significant association between lower olfactory threshold for bourgeonal and stronger sexual desire, in terms of IIEF1.
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