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Objectives: The aim was to find the relationship between nasal smear eosinophil (NSE) counts and allergic rhinitis (AR) along with the impact of treatment on peak nasal inspiratory flow rates and symptom scores in these patients. Material and methods: An observational, comparative study was carried out with 75 patients of AR. Nasal smears were drawn and eosinophil counts were estimated. Nasal symptoms were assessed and compared by visual analogue scale (VAS) and peak nasal inspiratory flow (PNIF) rates before and after treatment. Equal number of healthy individuals formed the control group. Results: There was a strong association between increase in eosinophil count in nasal smears and AR (p = 0.000). A NSE count of 0.2/HPF had a specificity of 98.7%, sensitivity of 53.3%, and positive predictive value of 97.6% in the diagnosis of AR. The mean VAS scores for nasal obstruction improved from 7.35 to 1.01 and the mean peak nasal inspiratory flow from 69.00 L/min to 103.73 L/min (p < 0.0001) after treatment. The mean NSE counts reduced from 4.20/HPF to 0.090/HPF proving a strong correlation between improvement of symptom scores and NSE counts (p = 0.000) in AR. The study also determined that a PNIF value of ≤ 77.50 L/min can be used as a cut off for diagnosing nasal obstruction in these patients. Conclusion: A NSE count of ≥ 0.2 /HPF is to be considered as diagnostic of AR. Nasal congestion is the commonest symptom associated with AR and addition of systemic decongestant is required for management of these patients.

Chronic Rhinosinusitis (CRS) is a common condition causing significant symptoms to those affected, cause burden to the healthcare consumption and productivity loss (Fokkens et al. in Rhinol J 58:82–111, 2020). Chronic Rhinosinusitis is diagnosed clinically on the basis of characteristic symptoms with inflammation of the mucosa of the nose and paranasal sinuses of at least 12 consecutive weeks duration (Fokkens et al. in A summary for otorhinolaryngologists Rhinology 50:1–12, 2012). Functional Endoscopic Sinus Surgery is a minimally invasive procedure recommended for chronic Rhinosinusitis. Patients are not routinely assessed specifically for functional and symptomatic improvement after surgery. Previous studies assessed either subjective or objective outcome of surgery (Elwany et al. in Eur Arch Otorhinolaryngol 255:511–514, 1998; Sino-nasal Outcome Test (SNOT-22): A predictor of post-surgical improvement in patients with chronic sinusitis – PMC, 2022. The present study assessed pre and post operative comparison of nasal mucociliary clearance, nasal patency and Sino-nasal outcome score and evaluated both subjective and objective outcomes of functional endoscopic sinus surgery simultaneously. To assess the effect of functional and symptomatic outcomes after Functional Endoscopic Sinus Surgery in patients with Chronic Rhinosinusitis visiting a tertiary care centre in South India. The present study was a hospital based cross-sectional study conducted in the Department of Otorhinolaryngology, in a tertiary care centre in South India, between February 2021 and May 2022. After obtaining informed consent all the patients fulfilling inclusion and exclusion criteria in the given time period were selected as the study population via consecutive sampling method. Detailed history, clinical examination and Diagnostic nasal endoscopy, Computed Tomography (CT) paranasal sinuses were done in all cases. Pre operative Saccharine transit time (STT), Peak nasal inspiratory flow rate (PNIFR) and Sino nasal outcome test (SNOT) 22 score were measured. All cases underwent Functional Endoscopic Sinus Surgery (FESS). Patients were followed up at 1st, 3rd and 6th month for functional and symptomatic outcomes. Data were analysed statistically using Friedman’s ANOVA test. A total of 40 patients between the age of 20 and 60 with Chronic Rhinosinusitis with /without nasal polyposis were analysed. Incidence was found to be more common in middle aged group (37.5%). Among the study group 52.5% were females and 47.5% were males 55% was diagnosed as Chronic Rhinosinusitis with nasal polyp (CRSwNP) type and 45% as without nasal polyp (CRSsNP) type. On comparing the variation of Saccharine transit time, Peak nasal inspiratory flow rate and SNOT 22 score with post operative results done at, 1st, 3rd and 6th months using Friedman’s ANOVA test showed statistically significant results ( P value < 0.05). According to our study there is significant improvement in functional and symptomatic outcomes after Functional Endoscopic sinus surgery and restoration of mucociliary function in Chronic Rhinosinusitis patients. Thus, FESS is an excellent choice for treatment of CRS.

Nasal obstruction requires close attention, as it is a risk factor for obstructive sleep apnea (OSA). This study evaluated airflow rates of our newly designed nasal breathing stent (NBS) compared with those of existing nasal dilators in 10 adult men. We hypothesized that the NBS would expand the nasal passage more than the other nasal dilators by means of airflow measurements. We compared airflow measurements between the NBS and three existing appliances and no appliance. Velocity measurements were recorded by analyzing 499 videographic images when each appliance was placed next to a steam generator at 0, 5, and 10 mm from the outlet port for airflow visualization. The peak nasal inspiratory flow (PNIF) rate was measured using an inspiratory flow meter. The NBS resulted in significantly higher airflow velocity measurements at all distances from the outlet port and a higher PNIF rate than the other appliances. Thus, the NBS offers a significantly decreased resistance to air movement compared with other appliances. Future in-depth investigations are required to demonstrate the use of NBS as a nasal dilator in conjunction with continuous positive airway pressure/oral appliance treatments in patients with OSA.

Purpose Nasal breathing (NB) is a fundamental physiological process, and emerging research indicates its potential role in modulating resting metabolism, impacting energy expenditure and metabolic efficiency. This study investigates the impact of NB on resting metabolic rate (RMR), offering novel insights into metabolic regulation. Methods A prospective study was conducted on patients undergoing nasal surgery, with measurements taken before and 3 months after surgery. Metabolic rate assessments, anthropometric dimensions, and peak nasal inspiratory flow (PNIF) were recorded. Factors like age, sex, and health status were considered to control for confounding variables. Results A total of 83 patients were initially enrolled: 17 underwent septorhinoplasty (SRP), 61 septoplasty (ST) and 5 inferior turbinate reduction alone. 72 patients completed the follow-up. SRP patients exhibited significantly higher pre- and post-operative RMR compared to ST patients (p = 0.005), and this association was not observed when PNIF was included in the analysis (p > 0.05). Pre-operative and post-operative PNIF values significantly correlated with pre-operative and post-operative RMR (p = 0.049 and p = 0.005, respectively). Post-operative PNIF predicted post-operative RMR after confoundment adjustment in linear regression (β = – 0.043, p = 0.017). Importantly, total body weight increased after surgery (pre-op: 74 ± 14.6 kg versus post-op: 75.6 ± 15.5 kg, p < 0.001) due to an increment in muscle mass (pre-op: 52.3 ± 12 versus post-op: 55.5 ± 14, p < 0.01). Conclusion Preliminary analysis suggests a potential link between NB and RMR, emphasizing the overlooked role of nasal respiratory physiology in energy homeostasis. Surgery also elicited body composition alterations. Further research is needed to uncover the underlying mechanisms of this association. Understanding the impact of NB on RMR could underscore its significance in metabolic regulation, reinforcing the importance of nasal surgery on overall health. This study provides foundation for future investigations.

To find out the improvement in cosmetic and functional aspects as measured using Rhinoplasty outcome evaluation questionnaire following Septorhinoplasty. To measure the increase in nasal airflow as measured using “Peak Nasal Inspiratory Flow meter” in patients undergoing Septorhinoplasty. Design: prospective cohort study. Settings: patients with complaints of nasal obstruction and external deformity who are undergoing Septorhinoplasty after evaluation. Subjects: patients undergoing Septorhinoplasty at Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla during a period of 1½ years, starting from 01/01/2017. Methods: non-random, consecutive sampling. The mean age in this study is 26.10 years. The most common age group of patients who were included in the study was 11–20 years. We had 11 females and 8 males. Female to male ratio was 1.375. The mean duration of symptom was 6.33 years. Most of the patients in our study were students. The mean pre-op ROE score was 29.79 ± 15.28 and post-op score was 87.32 ± 8.75. There was significant improvement in ROE scores following Septorhinoplasty (p < 0.0001). The mean pre-op PNIF score was 76.58 ± 41.37 and post-op score was 125 ± 50.22. There was significant improvement in PNIF scores following surgery (p < 0.0001). There is significant improvement in cosmetic and functional aspects in patients undergoing Septorhinoplasty. There is significant improvement in external appearance and nasal obstruction following Septorhinoplasty. The patient satisfaction following Septorhinoplasty can be measured with ease with the help of Rhinoplasty outcome evaluation questionnaire and Peak nasal inspiratory flow meter.

Allergic rhinitis is a chronic respiratory disease. Sympathetic hypofunction has been identified in allergic rhinitis patients. To investigate the effects of six weeks of repeated sauna treatment on the autonomic nervous system, peak nasal inspiratory flow (PNIF) and lung functions in Thai patients with allergic rhinitis. Subjects were diagnosed with allergic rhinitis clinically by an attending physician based on history, physical examination and positive reactions to a skin prick test. Subjects were randomly assigned to two groups. Controlsubjects received education and maintained a normal life. The sauna group received sauna treatment over a six-week period, 3 days per week, with 6 sets of 5 minutes per set per day, totaling 30 minutes. Each 5 minute set alternated with a 5 minute period of rest. Heart rate variability (HRV), peak nasal inspiratory flow and lung function were measured at the beginning and after three and six weeks of sauna treatment. The HRV measurement is composed of three components, including low frequency (indicating sympathetic function in normal units or n.u.), high frequency (indicated parasympathetic function in n.u.), and the ratio of LF/HF (indicating the balance of the autonomic system). Twenty-six allergic rhinitis patients, 12 males and 14 females participated in this study, 13 in the control group and 13 in the sauna treatment group; there were 6 males in each group. Baseline characteristics for the control and sauna treatment groups were comparable. There were significant changes in the HRV after six weeks of sauna treatment. The high frequency component was significantly lower in sauna treatment group (51.8 vs 35.4), while the low frequency component and LF/HF ratio were significantly higher in sauna treatment group than in the control group (48.1 vs 64.5 and 0.9 vs 2.5, respectively). The PNIF and the forced expiratory volume in one second, or FEV1, were also significantly higher in sauna treatment group (103.0 vs 161.9 and 80.1 vs 95.6, respectively). The six weeks of repeated sauna treatment can increase sympathetic activity, PNIF, and FEV1 in Thai patients with allergic rhinitis.

The aim of this study was to investigate the impact of high altitude on nasal and lower airway parameters in a healthy population. This was a prospective study of 61 individuals who climbed to the summit of Mount Kackar, at 3,937 m. Peak nasal inspiratory flow rates were recorded in all participants at sea level and at the summit. In 32 participants who ascended to the summit, sea-level and summit peak expiratory flow rates and olfactory function were evaluated. A rise in altitude significantly decreased peak nasal inspiratory flow by a mean of 27.43%. Mean peak expiratory flow values measured at the summit were 8.94% lower than basal values. Between-value differences were statistically significant ( p  < 0.001, p  < 0.05). At high altitude, there was a significant decrease in olfactory function, as determined by a significant reduction in smell detection ( p  < 0.05) and smell identification ( p  < 0.05). The effect of high altitude on nasal function was found to parallel that of the effect on lower airway function, together accounting for an adverse effect on airway flow rates. The nasal mucosa responded to high altitude with an increase in airway resistance and a consequent impaired sense of smell.

Altered nasality influences speech intelligibility. Automatic speech recognition (ASR) has proved suitable for quantifying speech intelligibility in patients with different degrees of nasal emissions. We investigated the influence of hyponasality on the results of speech recognition before and after nasal surgery using ASR. Speech recordings, nasal peak inspiratory flow and self-perception measurements were carried out in 20 German-speaking patients (8 women, 12 men; aged 38 ± 22 years) who underwent surgery for various nasal and sinus pathologies. The degree of speech intelligibility was quantified as the percentage of correctly recognized words of a standardized word chain by ASR (word recognition rate; WR). WR was measured 1 day before (t1), 1 day after with nasal packings (t2), and 3 months after (t3) surgery; nasal peak flow on t1 and t3. WR was calculated with program for the automatic evaluation of all kinds of speech disorders (PEAKS). WR as a parameter of speech intelligibility was significantly decreased immediately after surgery (t1 vs. t2 p  < 0.01) but increased 3 months after surgery (t2 vs. t3 p  < 0.01). WR showed no association with age or gender. There was no significant difference between WR at t1 and t3, despite a post-operative increase in nasal peak inspiratory flow measurements. The results show that ASR is capable of quantifying the influence of hyponasality on speech; nasal obstruction leads to significantly reduced WR and nasal peak flow cannot replace evaluation of nasality.