Acoustic Rhinometry Usefulness in Choosing Surgical Therapy in Patients with Allergic Rhinitis.
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概要
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Nasal obstruction is an important symptom in allergic rhinitis. Several types of nasal surgery instruments have been reported useful in reducing nasal obstruction. Structural problems such as deviation of the nasal septum may, however, also influence nasal obstruction often necessitating septoplasty. This makes it important to clarify factors in nasal obstruction before deciding how to treat allergic rhinitis.Acoustic rhinometry, introduced by Hilberg (1989) measures the degree of openness of the nose or its parts. Several authors have reported the responsiveness of nasal patency to methacholine provocation with acoustic rhinometry.We measured the change in nasal patency and nasal responsiveness to acoustic rhinometry before nasal surgery in patients with allergic rhinitis and studied surgical options in allergic rhinitis.Subjects were 30 patients with perennial allergic rhinitis and mild or severe nasal obstruction. Of these, 11 underwent inferior turbinectomy and septoplasty with the inspection of nasal symptoms and radiographic examination. The 19 underwent conservative therapy. Minimum nasal cross-sectional area and nasal response to methacholine nasal spray were compared between groups using an acoustic rhinometer (RHIN2100 Rhinometrics co. Denmark). Measurement with acoustic rhinometry was also studied after a topical nasal decongestant was administered.We found values and parts of minimum nasal cross-sectional area in both groups to statistically the same. We found the difference in decongested minimum cross-sectional area between the left and right sides of the nose was useful in evaluating the degree of deviation in the nasal septum. The narrowed cross-sectional area in the surgical group was statistically wider than in the non-surgical group (p<005). Hyperresponsiveness to methacholine nasal provocative test did not differ between groups in our study. These results suggest, however, investigation of the effect of both mucosal and structural factors is important in deciding allergic rhinitis treatment.In conclusion, evaluation of the value and wideness of cross-sectional area is useful in determining nasal surgery in patients with allergic rhinitis.
- 日本鼻科学会の論文
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