Sensation of nasal obstruction compared to rhinomanometric results in patients referred for septoplasty

In previous studies concerning correlations between subjective nasal obstruction and rhinomanometric findings the subjects quite often had normal nasal status and symptomless nasal breathing. The correlation sometimes proved to be poor. In the present study, intercorrelations between rhinomanometry and subjective sensation of nasal patency were evaluated in 102 patients referred for septoplasty. The hypothesis was that this material should give more realistic results than normal cases. In pre-operative rhinomanometry it was found that in 62 cases the nasal airway resistance (NAR) after decongestion of the nasal mucosa was pathological compared to our normal material and in 40 cases it was within normal range. The patients were asked, before rhinomanometric recording, to indicate the narrower side of the nose, right or left. After that, both baseline and post-decongestion recordings were made. The rhinomanometric results concerning the side difference were compared to the subjective assessment. Our results showed that in the 62 cases with pathological NAR the subjective and rhinomanometric evaluation was consistent in 46 of the baseline and 50 of the decongestion cases. In the 40 patients with normal NAR the figures were 19 and 20, respectively. It is obvious that if NAR is low it is more difficult for the patient to determine the more obstructed side. We conclude that rhinomanometry rather than the subjective sensation of the subject is more suited to detect subtle side difference in resistance between the nares.