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S273 – Does Nasal Obstruction Mean that the Nose Is Obstructed?
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Otolaryngology-Head and Neck Surgery, Vol 139, No 2S1, August 2008
a visual analog scale. A rhinomanometric evaluation was conducted prior to and after the procedure. All patients were asked to evaluate the improvement of their symptoms. All patients’ data and potential complications were put in a database and were statistically assessed. RESULTS: Statistical analysis showed significant improvement of their symptoms and of rhinomanometric results. No complications or side effects occurred. The mean operative time was 35 minutes. CONCLUSIONS: Septal cartilage reshaping is an easy, painless, and bloodless method using an Erbium doped glass fiber Laser. Laser device LSC-701 (Arcuo Medical Inc.) is an effective, safe, and inexpensive medical equipment. S272 – Diagnostic and Staging Accuracy of MRI vs. CT in CRS Harrison W Lin, MD (presenter); Neil Bhattacharyya, MD OBJECTIVES: Determine the correlation between computed tomography (CT)- and magnetic resonance imaging (MRI)based staging and classification of chronic rhinosinusitis (CRS). METHODS: Paired CT and MRI scans of 89 adult patients who were imaged by both modalities within a 3-month time period for evaluation of pituitary disease were scored for sinus disease using the Lund-Mackay system in a randomized and blinded fashion. The Lund scores were compared for similarity, correlation, and diagnostic classification between modalities. RESULTS: The mean Lund scores were 2.3 ⫾ 0.6 (95% CI) for CT-based staging and 2.1 ⫾ 0.5 for MRI-based staging with a median time interval between scans of 3 days. The difference in means was not statistically significant (p⫽0.444, paired t-test). Correlation analysis revealed a significant association between CT- and MRI-based scores (Pearson’s r⫽0.837, p⬍0.001). Disease classification agreement analysis using published Lund score cutoffs (3 versus 4) for the likelihood of true sinus disease revealed that CT- and MRI-based scoring agreed on 76 cases (85.4%). Disagreement in disease classification occurred in 13 cases (7 MRI positive but CT negative and 6 CT positive but MRI negative) for a kappa value of 0.557 (p⬍0.001). CONCLUSIONS: Lund-Mackay staging of sinus disease by MRI is closely correlated to corresponding staging based on CT. MRI does not significantly over-stage or over-classify patients with sinus disease. S273 – Does Nasal Obstruction Mean that the Nose Is Obstructed? Thomas Kjaergaard (presenter); Milada Småstuen Cvancarova, MSc; Sverre Steinsvåg, MD, PhD
OBJECTIVES: To what extent a sense of nasal obstruction correlates with objective measures for nasal space and air flow is still a matter of controversy. Knowledge about this is important in the evaluation of nasal complaints and the planning of treatment. The primary objectives of our study were to evaluate the relationship between subjective nasal blockage and 1) acoustic rhinometry (AR), and 2) Peak Nasal Inspiratory Flow (PNIF). METHODS: 2341 consecutive patients referred to ENT specialist for evaluation of obstructive sleep apnea, snoring, or nose-related complaints were included in this cross-sectional study. Subjects underwent AR and nasal flow measurements (PNIF). Subjective grading of nasal obstruction was obtained by a Visual Analogue Scale (VAS). Associations between VAS recordings and measurements of PNIF and AR were evaluated with multivariate analysis using linear regression, adjusting for age, sex, body mass index, asthma, allergy and smoking history. The study was conducted in the period 20052007. RESULTS: The sense of nasal obstruction was correlated to volumes in both anterior and middle segments of the nasal cavities (p⬍0,001), to minimal cross-sectional areas in middle segments, and for the nasal airway as a whole (p⬍0,001) and to PNIF (p⬍0,001). CONCLUSIONS: The present study indicates that there are significant correlations between the subjective sensation of nasal obstruction and the corresponding measures for space and air flow. We conclude that AR and PNIF are valuable objective investigational tools correlating well with the sensation of nasal obstruction. S274 – Smoker’s Nose Thomas Kjaergaard (presenter); Milada Småstuen Cvancarova, MSc; Sverre Steinsvåg, MD, PhD OBJECTIVES: Do smokers have more upper airway symptoms than non-smokers? Despite extensive knowledge about the health-damaging effects of smoking, little is known about whether and to what extent smoking causes complaints from the upper airway. The main objectives of our study: 1) evaluate the role of cigarette smoking in relation to upper airway symptoms, and 2) study the dose response relationship between daily cigarette consumption and upper airway symptoms. METHODS: 2294 consecutive patients referred to ENT specialist for evaluation of obstructive sleep apnea, snoring or nose-related complaints were included in this cross-sectional study. Subjects completed a detailed questionnaire including Visual Analogue Scales (VAS), grading 13 upper airway symptoms. In addition, smoking habits were registered. Associations between VAS recordings and smoking status were evaluated by multivariate analysis based on regression analysis and Anova, adjusting for age, sex, body mass index, asthma, and allergy. Differences of 10% or more were considered
Otolaryngology-Head and Neck Surgery, Vol 139, No 2S1, August 2008
a visual analog scale. A rhinomanometric evaluation was conducted prior to and after the procedure. All patients were asked to evaluate the improvement of their symptoms. All patients’ data and potential complications were put in a database and were statistically assessed. RESULTS: Statistical analysis showed significant improvement of their symptoms and of rhinomanometric results. No complications or side effects occurred. The mean operative time was 35 minutes. CONCLUSIONS: Septal cartilage reshaping is an easy, painless, and bloodless method using an Erbium doped glass fiber Laser. Laser device LSC-701 (Arcuo Medical Inc.) is an effective, safe, and inexpensive medical equipment. S272 – Diagnostic and Staging Accuracy of MRI vs. CT in CRS Harrison W Lin, MD (presenter); Neil Bhattacharyya, MD OBJECTIVES: Determine the correlation between computed tomography (CT)- and magnetic resonance imaging (MRI)based staging and classification of chronic rhinosinusitis (CRS). METHODS: Paired CT and MRI scans of 89 adult patients who were imaged by both modalities within a 3-month time period for evaluation of pituitary disease were scored for sinus disease using the Lund-Mackay system in a randomized and blinded fashion. The Lund scores were compared for similarity, correlation, and diagnostic classification between modalities. RESULTS: The mean Lund scores were 2.3 ⫾ 0.6 (95% CI) for CT-based staging and 2.1 ⫾ 0.5 for MRI-based staging with a median time interval between scans of 3 days. The difference in means was not statistically significant (p⫽0.444, paired t-test). Correlation analysis revealed a significant association between CT- and MRI-based scores (Pearson’s r⫽0.837, p⬍0.001). Disease classification agreement analysis using published Lund score cutoffs (3 versus 4) for the likelihood of true sinus disease revealed that CT- and MRI-based scoring agreed on 76 cases (85.4%). Disagreement in disease classification occurred in 13 cases (7 MRI positive but CT negative and 6 CT positive but MRI negative) for a kappa value of 0.557 (p⬍0.001). CONCLUSIONS: Lund-Mackay staging of sinus disease by MRI is closely correlated to corresponding staging based on CT. MRI does not significantly over-stage or over-classify patients with sinus disease. S273 – Does Nasal Obstruction Mean that the Nose Is Obstructed? Thomas Kjaergaard (presenter); Milada Småstuen Cvancarova, MSc; Sverre Steinsvåg, MD, PhD
OBJECTIVES: To what extent a sense of nasal obstruction correlates with objective measures for nasal space and air flow is still a matter of controversy. Knowledge about this is important in the evaluation of nasal complaints and the planning of treatment. The primary objectives of our study were to evaluate the relationship between subjective nasal blockage and 1) acoustic rhinometry (AR), and 2) Peak Nasal Inspiratory Flow (PNIF). METHODS: 2341 consecutive patients referred to ENT specialist for evaluation of obstructive sleep apnea, snoring, or nose-related complaints were included in this cross-sectional study. Subjects underwent AR and nasal flow measurements (PNIF). Subjective grading of nasal obstruction was obtained by a Visual Analogue Scale (VAS). Associations between VAS recordings and measurements of PNIF and AR were evaluated with multivariate analysis using linear regression, adjusting for age, sex, body mass index, asthma, allergy and smoking history. The study was conducted in the period 20052007. RESULTS: The sense of nasal obstruction was correlated to volumes in both anterior and middle segments of the nasal cavities (p⬍0,001), to minimal cross-sectional areas in middle segments, and for the nasal airway as a whole (p⬍0,001) and to PNIF (p⬍0,001). CONCLUSIONS: The present study indicates that there are significant correlations between the subjective sensation of nasal obstruction and the corresponding measures for space and air flow. We conclude that AR and PNIF are valuable objective investigational tools correlating well with the sensation of nasal obstruction. S274 – Smoker’s Nose Thomas Kjaergaard (presenter); Milada Småstuen Cvancarova, MSc; Sverre Steinsvåg, MD, PhD OBJECTIVES: Do smokers have more upper airway symptoms than non-smokers? Despite extensive knowledge about the health-damaging effects of smoking, little is known about whether and to what extent smoking causes complaints from the upper airway. The main objectives of our study: 1) evaluate the role of cigarette smoking in relation to upper airway symptoms, and 2) study the dose response relationship between daily cigarette consumption and upper airway symptoms. METHODS: 2294 consecutive patients referred to ENT specialist for evaluation of obstructive sleep apnea, snoring or nose-related complaints were included in this cross-sectional study. Subjects completed a detailed questionnaire including Visual Analogue Scales (VAS), grading 13 upper airway symptoms. In addition, smoking habits were registered. Associations between VAS recordings and smoking status were evaluated by multivariate analysis based on regression analysis and Anova, adjusting for age, sex, body mass index, asthma, and allergy. Differences of 10% or more were considered