Assessment of nasal obstruction: Correlation between subjective and objective techniques
Open accessAbstract
Background Nasal sensation of airflow describes the perception of the passage of air through the nose. Nasal obstruction can be assessed using subjective techniques (symptom scores and visual analogue scales [VAS]) and objective techniques (anterior rhinomanometry [RMN], acoustic rhinometry [AR], and peak nasal inspiratory flow [PNIF]). Few studies have evaluated the correlation between these techniques. Objective The primary objective of our study was to determine the degree of correlation between subjective and objective techniques to assess nasal obstruction. Materials and methods Nasal obstruction was assessed using a symptom score, VAS, RMN, AR (minimal cross-sectional area [MCSA] and volume), and PNIF in 184 volunteer physicians. Spearman's rho was recorded. Correlations were considered weak if r ≤ 0.4, moderate if 0.4 0.8. Results Mean (SD) age was 37.1 (6.9) years (range, 25-56 years); 61% were women. We found a strong correlation (r > 0.8; p = 0.001) between the different parameters of RMN and a moderate correlation between symptom score and VAS (r = 0.686; p = 0.001) and between MCSA and RMN (resistance) (r = 0.496; p = 0.001) and PNIF (r = 0.459; p = 0.001). The correlations were weak or non-significant for the remaining comparisons. Conclusion Nasal obstruction can be assessed using subjective and objective approaches. The correlations between objective techniques were moderate to strong. In addition, between subjective techniques we reported a moderate correlatio…
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The visual analog scale is a well-studied tool for assessing the severity of nasal obstruction and has been validated with reference to other subjective measures such as symptom score and to objective measures such as rhinomanometry, acoustic rhinometry, and peak nasal inspiratory flow in adults and nasal endoscopy in children.
“The VAS is a well-studied tool for assessing the severity of NO and has been validated with reference to other subjective measures such as symptom score [31] and to objective measures such as rhinomanometry (RMN), acoustic rhinometry (AcR), and peak nasal inspiratory flow (PNIF) in adults [32,33] and nasal endoscopy in children [34].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
The Likert scale score on nasal obstruction has been validated by comparing it with the visual analog scale and acoustic rhinometry.
“The Likert scale score on NO has been validated by comparing it with the VAS and AcR [31].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
PNIF ability to discriminate healthy individuals from patients is similar to that of AARMN.
“Its ability to discriminate healthy individuals from patients is similar to that of AARMN [31,75].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
Cut-off values of 115-120 L/min have been suggested to distinguish normality from obstruction on PNIF.
“Cut-off values of 115-120 L/min have been suggested to distinguish normality from obstruction [31,57,63,64]”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
Yepes-Nuñez et al found a moderate correlation (r=0.68) between VAS and a symptom scale for subjective NO evaluation.
“The correlation found between these subjective methods was moderate (r=0.68).”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
PNIF was moderately correlated with AcR (r=0.45) and weakly correlated with AARMN (r=0.25).
“PNIF was moderately correlated with AcR (r=0.45) and weakly correlated with AARMN (r=0.25).”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
There are no absolute values of normality for PNIF.
“although there are no absolute values of normality and the patient is the best judge for evaluating changes.”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
A wide range of values of normality for PNIF have been published in adults and children.
“A wide range of values of normality have been published in adults [31,44,58-61] and children [58-61].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
The relationship of PNIF with the symptom score measured using a VAS is controversial.
“Its relationship with the symptom score measured using a VAS is controversial [31,63,68,69]”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
A moderate correlation was detected between the MTA value and resistance, while correlations between other AARMN and AcR variables were weak.
“A moderate correlation was detected between the MTA value and resistance, although correlations between the other variables were weak.”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [31]
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Position Paper on Nasal Obstruction: Evaluation and Treatment
SEAIC Rhinoconjunctivitis Committee & SEORL Rhinology, A., Valero, A., Navarro, A., del Cuvillo, A., Alobid, I., Benito, Jr., Colás, C., de los Santos, G., Fernández Liesa, R., García-Lliberós, A., et al. (2018) · Journal of Investigational Allergology and Clinical Immunology · doi:10.18176/jiaci.0232 · Cited by 76 · see citing works
Self-citationKuan, E. C., Suh, J. D., & Wang, M. B. (2015) · Current Allergy and Asthma Reports · doi:10.1007/s11882-014-0493-x · Cited by 75 · see citing works
- Authors
- Yepes-Nuñez, J. J., Bartra, J., Muñoz-Cano, R., Sánchez-López, J., Serrano, C., Mullol, J., Alobid, I., Sastre, J., Picado, C., & Valero, A.
- Affiliations
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES)
- Hospital Clínic de Barcelona (ES)
- Fundación Valle del Lili (CO)
- Corresponding author
- Valero, A.
- Venue
- Allergologia et Immunopathologia
- Publisher
- Codon Publications
- Published
- 2013-11
- Volume
- 41
- Issue
- 6
- Pages
- 397-401
- ISSN
- 0301-0546 (ISSN-L)
- OpenAlex
- W2060596372
- Cited by
- 79
- References
- 0
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 6 · 2023: 8 · 2022: 9 · 2021: 9 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 3 · 2014: 10 · 2013: 3
- FWCI
- 5.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Allergologia et Immunopathologia (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repository University of Antioquia (University of Antioquia) (publishedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- nasal obstruction, subjective evaluation, objective assessment, anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow, nasal symptom score, visual analogue scale, minimal cross-sectional area
- MeSH terms
- Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Respiratory Function Tests, Volunteers, Nasal Obstruction, Rhinometry, Acoustic, Rhinomanometry, Visual Analog Scale
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