The Role Of Acoustic Rhinometry In Nasal Septum Deviation

BackgroundNasal septum deviation is the most common disease in rhinology. Its clinicalcharacters mainly include symptoms of congestion, headache and nose bleeding. Andamong the most common complaint is nasal congestion. Surgery is the main methodused to alleviated nasal obstruction in these patients. At present, assessment of nasalseptum deviation still lacks of objective basis as it mostly depends on the subjectivefeeling of the patients and doctor’s examination.Acoustic rhinometry (AR) as an objective method for examining the nasal cavityis applied the principle of sound reflection to the measure of nasal space, which issimple, quick, accurate, and noninvasive. Even though some researchers had carriedout studies on the correlation between the subjective feeling of nasal obstruction andAR parameters, some controversies still existed. In the previous studies the measuringsite of AR limited in the first two narrow of nasal cavity, and the measurement of thenasal cavity volume was not precise enough as well, which hardly reflected thespecific location relevant to the actual location of the deviation. Therefore, wesubdivided the nasal cavity into several sections and measured the volume of the deviation sections. It can help us diagnose and evaluate the effect of surgery treatmentfor septum deviation.Objective1、Measure the cross-sectional area and volume of nasal cavity in differentsections, including deviation sections, analyze variances between the normalgroup, physiologic deviation group and patient group.2、Analyze the correlation between the acoustic rhinometry parameters andVisual Analogue Scale (VAS) of nasal obstruction, find the objectiveevidence for diagnosis and surgery choice.Methods and Materials1. Study Subjects：1、normal group：66people were randomly selected from the otolaryngologyhead and neck surgery department of sun yat-sen memorial hospital between January2011and January2012, The selective standard reference the normal adult in literature[1]。2、patient group: Select75patients with unilateral or bilateral stuffy nose andwere diagnosed as septum deviation by doctor’s examination in the same period, ruleout the patients with alar collapse, sinusitis, nasal neoplasm, nose trauma and septumsevere deviation whose date can’t be obtained by AR.3、physiologic deviation group: Select20people with septum deviation butwithout symptom, rule out the patients with alar collapse, sinusitis, nasal neoplasm,nose trauma and septum severe deviation whose date can’t be obtained by AR。2. Methods：The cross-sectional area, distance and volume of nasal cavity in differentsections, include deviation sections, were measured by acoustic rhinometry (AR). The patients were measured again after the surgery. Visual analogue scale (VAS) was usedto estimate the degree of subjective feeling before the acoustic rhinometry. Thedistance (d) from the convex point of the deviated septa to nostril were measured byusing the reconstructive technique of spiral CT.3. Statistical Analysis：All the data were analyzed with SPSS17.0for windows. Statistical test were usedaccording to different types of the date. P <0.05was considered statisticallysignificant.Results：1. The difference of MCA2, MCA3, MD3, V2~3, V3~5, V0~7between the nasalcavity of normal group and the blocking nasal cavity of patient group havestatistically significant.2. The differences of MCA2, MD3between the nasal cavity of normal group andthe physiologic deviation group have statistically significant.3. The difference of MD2, V2~3, between the physiologic deviation group and theblocking nasal cavity of patient group have statistically significant.4. The difference of MD2, MCA2, MCA3, V1~2, V2~3, V3~5, V0~7betweenpreoperative and postoperative group have statistically significant.5. The difference of MCA2、MD2、MCA3、V2~3、V3~5、V0~7betweenpreoperative and the physiologic deviation group have statistically significant.6. The difference of V3~3.5between the nasal cavity of normal group and the nasalcavity which convex point lies in the same section have statistically significant.7. In the nasal cavity which convex point lies in the section of3~3.5cm from nostril,the difference of V3~3.5between preoperation and postoperation havestatistically significant.8. The VAS score before operation was negatively correlated with MCA2, MCA3,V2~3, V3~5, V0~7in preoperative group. 9. The change of the VAS score between preoperation and postoperation werenegatively correlated with the change of MCA3, V3~5and V0~7betweenpreoperation and postoperation.Conclusions:1. Acoustic rhinometry could be supplement of endoscope and CT to providequantitative evidence for nasal septum.2. There is good consistency of the improvement of acoustic rhinometry and the VASscore, in the other word, acoustic rhinometry could be used to evaluate the effect ofsurgery treatment for septum deviation.