The Clinical Application Value Of Nasal Functional Diagnosis System In Nasal Obstruction Patients After Surgery

Background and purposeNasal obstruction is the common disease in otolaryngology clinical work.There are a lot of reasons leading to nasal obstruction,and they are very different in adults, infants and children.The evaluation of the degree about nasal obstruction mainly based on the subjective feeling of patients.The surgical treatment is one of the main means to treat nasal obstruction in clinical treatments,and the improvement of nasal congestion degree imainly rely on their own subjective feeling.So the degree of nasal obstruction and the evaluation of postoperative effect lack objective reference and indicators.Nasal functional diagnosis system includes acoustic rhinometry, rhinomanometry and nasal respiratory volume,and it has been widely used in otolaryngology clinical work recently. It can objectively reflect the degree of nasal obstruction, location and nature,and has the function of comparison before and after operation.It objectively reflects the operation effect,overcomes the problem between patients, complaints and the reality,and avoids doctor-patient conflicts effectively.This paper summarizes150patients with nasal obstruction admitted by our department in November2011-December2012(60patients in group A;deflection of nasal septum group,chronic sinusitis group and the occupying of accessory nasal cavity group,30cases each one).We gave endoscopic surgery depending on the condition of the patients respectively.In the same time,the patients accept nasal function examination before and after operation.At the same time,choose normal adult control group and normal children control group for each30cases, each parallel the functional testing and contrast with nasal obstruction groups.We make statistical analysis for each group and explore the clinical application value of nasal functional diagnosis system in endoscopic surgery.Methods150patients with nasal obstruction can be divided into four groups, namely the adenoid hypertrophy group (group A,30patients with adenoid hypertrophy alone in group a, patients with adenoid and tonsillar hypertrophy in group b), the deflection of nasal septum group (group B), chronic sinusitis group (group C) and the occupying of accessory nasal cavity group(group D), and receive nasal function examination before and after operation.Each clinical datas were retrospectively analyzed, normal adult control group E and normal children group F respectively did the functional test and made statistical analysis.ResultsIn the group E(normal adult control group),the bilateral NMCA was1.48±0.12cm2,the bilateral NCV was18.67±1.49cm3,the bilateral NAR was0.182±0.017kPa-s/L,the bilateral VT was8.194±0.312L;the unilateral NMCA was0.72±0.06cm2,the unilateral NCV was10.16±0.51cm3,the unilateral NAR was0.341±0.030kPa-s/L,the unilateral VT was4.014±0.306L.In the group F(normal children control group),the bilateral NMCA was0.70±0.12cm2,the bilateral NPV was19.05±1.62cm3,the bilateral NAR was0.225±0.052kPa-s/L,the bilateral VT was6.321±0.615L.In the group A(adenoid hypertrophy group), before the operation the patients, NMCAwas0.65±0.12cm2,NPV was12.20±2.16cm3,NARwas0.301±0.040kPa-s/L,VT was3.444±0.344L;3month later after the operation, NMCAwas0.72±0.10cm2,NPV was19.60±1.78cm3,NAR was0.239±0.043kPa-s/L,VT was6.429±0.535L. Compared with preoperation and postoperation,NMCA,NPV,VT were improved, NAR was reduced, and the difference were statistically significant (P<0.05);compared with normal children group,there was no significant difference in each test indicators (P>0.05).In the group B(the deflection of nasal septum group),before the operation the patients’ NMCA was0.59±0.17cm2,NCV was8.13±1.24cm3,NAR was0.421±0.031kPa·s/L,VT was5.024±0.521L;3month later after the operation, NMCA was1.57±0.19cm2,NCV was19.04±2.43cm3,NAR was0.176±0.029kPa-s/L,VT was8.212±0.461L.Compared with preoperation and postoperation,NMCA,NCV,VTwere improved, NAR was reduced, and the difference were statistically significant (P<0.05);compared with normal adult group,there was no significant difference in each test indicators (P>0.05).In the groupC(chronic sinusitis group),before the operation the patients, NMCA was0.67±0.13cm2,NCV was8.03±1.68cm3,NAR was0.407±0.055kPa·s/L,VT was4.926±0.615L;3month later after the operation, NMCA was1.46±0.27cm2,NCV was19.14±3.50cm3,NAR was0.179±0.035kPa-s/L,VT was8.013±0.660L. Compared with preoperation and postoperation,NMCA,NCV,VT were improved, NAR was reduced, and the difference were statistically significant (P<0.05);compared with normal adult group,there was no significant difference in each test indicators (P>0.05).In the group D(the occupying of accessory nasal cavity group),before the operation the patients,NMCA was0.26±0.08cm2,NCV was5.09±1.27cm3,NAR was1.605±0.409kPa-s/L,VT was0.936±0.320L;3month later after the operation, NMCA was0.58±0.07cm2,NCV was10.33±1.75cm3,NAR was0.323±0.076kPa-s/L,VT was3.909±0.830L. Compared with preoperation and postoperation,NMCA,NCV,VT were improved, NAR was reduced, and the difference were statistically significant (P<0.05);compared with normal adult group,there was significant difference in NMCA (P<0.05) and no significant difference in NCV, NAR,VT (P>0.05).ConclusionsMaking the nasal function examination preoperatively, we can judge the degree and position of nasal obstruction accurately, and it can help select and complete the operation.After the operation examin again and compare with preoperation, it can present the operation effect objectively,directly and effectively.And the nasal functional diagnosis system can be used to evaluate the degree objectively and exactly.So in some degree,the nasal functional diagnosis system can be used to the objective evaluation index in the evaluation of degree of nasal obstruction and the effect of nasal endoscopic surgery.