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Clinical Assessment of Nasal Airway Obstruction

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All Around the Nose

Abstract

For the evaluation of nasal airway obstruction physical examination, anterior rhinoscopy, laboratory workup, imaging studies, and rhinomanometric studies may be required. Laboratory workup may consist of counts of neutrophil investigating infectious diseases, eosinophil for allergy-related disorders, and mast cell in food allergy. Imaging workup contains computed tomography (CT) and magnetic resonance imaging. Physically based studies involve rhinomanometry and acoustic rhinometry techniques. Nasal resistance is responsible for more than 50% of the resistance of the total airway. Nasal resistance is made up of two layers: the deeper layer consists of underlying bone, cartilage, and muscle, while superficially the overlying mucosa forms the second layer. Environmental and intrinsic conditions both alter nasal resistance. Variables reducing resistance consist of sympathomimetics, atrophic rhinitis, exercise, rebreathing, along with erect posture. Exercise leads to sympathetic vasoconstriction and shrinkage of the ala nasi, dilating the nasal cavities. Infectious rhinitis, vasomotor rhinitis, allergic rhinitis, supine posture, hyperventilation, cold air, aspirin, and alcohol increase nasal resistance. To better understand the relations between form and resistance of the nasal air channel, one of the basic laws in fluid dynamics is very helpful. The law of Hagen–Poiseuille is valid for the resistance of round tubes, which means that in a tube, the resistance R increases linear with the viscosity of the fluid and the length of the tube but with the 4 power of the tube radius. Reducing the radius to the half leads to a 16-fold increase of resistance.

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Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Bayindir Içerenköy Hospital, Istanbul, Turkey

    Ethem Sahin

  2. Department of Otorhinolaryngology, Beykent University, İstanbul, Turkey

    Burak Çakır

  3. Faculty of Medicine, Centre of Experimental Surgery, University of Latvia, Riga, Latvia

    Klaus Vogt

Authors
  1. Ethem Sahin
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  2. Burak Çakır
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  3. Klaus Vogt
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Corresponding author

Correspondence to Ethem Sahin .

Editor information

Editors and Affiliations

  1. Eskişehir Osmangazi University, Medical Faculty, Department of Otorhinolaryngology, Eskisehir, Turkey

    Cemal Cingi

  2. Department of Otorhinolaryngology, Medical Faculty, Kirikkale University, Kirikkale, Turkey

    Nuray Bayar Muluk

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Sahin, E., Çakır, B., Vogt, K. (2020). Clinical Assessment of Nasal Airway Obstruction. In: Cingi, C., Bayar Muluk, N. (eds) All Around the Nose. Springer, Cham. https://doi.org/10.1007/978-3-030-21217-9_11

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  • DOI: https://doi.org/10.1007/978-3-030-21217-9_11

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