ENT Congress 2019: Nasal obstruction: a modern view of the problem- Budkovaia Marina- St. Petersburg Research Institute

Nasal breathing disorder leads to the complex formation of pathological conditions and reduces significantly the quality of patients’ life. Particular difficulties arise when patients’ complaints of nasal breathing difficulty do not correspond with the results of rhinoscopic picture of the nasal cavity, as well as when patient is dissatisfied with the results of surgical treatment in relation to the restoration of respiratory function of the nose. In order to solve this problem, we conducted an objective diagnosis of nasal breathing disorders with the calculation of the main aerodynamic parameters of the nasal flow and a differential analysis of the causes of nasal obstruction formation, followed by a comparison of the identified changes to the results of multispiral computed tomography(CT) of the paranasal sinuses and nasal endoscopy examination of the nasal cavity and motor activity evaluation of the nasal cavity shimmering epithelium. This diagnostic complex is used in the examination of patients with subjective nasal breathing disorders before the planned surgical treatment and in  long term after surgical correction of the external nose, intra-nasal structuresand in the selection of patients with allergic rhinitis for allergic - specific immunotherapy. Simultaneous analysis of the parameters of anterior active rhinomanometry (AARM), rhinoresistometry and acoustic rhinometry before and after the test with decongestant allows to identify objectively or exclude the presence of nasal obstruction, to differentiate the causes of nasal breathing disorders into functional, structural and combined. The registered changes in the proposed method are compared with the results of nasal endoscopy and CT of the sinuses of the nose and are used to determine conservative or surgical management of patients to achieve good functional result and objective control of the effectiveness of nasal breathing restoration.

Author(s): Budkovaia Marina, Artemyeva Elena

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