Ana Claudia Martins Sampaio-Teixeira

Volumes nasais de adultos aferidos por rinometria acústica

Acoustic rhinometry allows an objective and non-invasive assessment of nasal geometry. AIM: The present study aimed at determining the volumes of specific segments of the nasal cavity in healthy adults including the nasopharynx, using acoustic rhinometry. Study design: A clinical prospective analysis. CASES AND METHOD: Thirty volunteers with no evidence of nasal obstruction, aged 18 to 30 years (14 males and 16 females) were analyzed. Volumes were measured at the nasal valve region (V1), the turbinates (V2), and the nasopharynx (V3), before and after application of a topical nasal vasoconstrictor. RESULTS: The mean volumes measured in 60 cavities before nasal decongestion, were: 1.81±0.35cm3 (V1), 4.02±1.41cm3 (V2), and 17.52±4.44cm3 (V3) for males, and 1.58±0.25cm3 (V1), 3.94±1.03cm3 (V2), and 17.80±2.73cm3 (V3) for females. Gender differences were only significant in V1 (p<0.05). After nasal decongestion, the volumes of all the analyzed segments were significantly larger (p<0.05), and the gender differences were significant for V1 and V2. CONCLUSION: Volumes of the three segments in adults with no evidence of nasal obstruction may be used as reference values for other studies.

Objective assessment of internal nasal dimensions and speech resonance in individuals with repaired unilateral cleft lip and palate after rhinoseptoplasty.

The objective of the current study was to analyze the effects of rhinoseptoplasty on internal nasal dimensions and speech resonance of individuals with unilateral cleft lip and palate, estimated by acoustic rhinometry and nasometry, respectively. Twenty-one individuals (aged 15-46 years) with previously repaired unilateral cleft lip and palate were analyzed before (PRE), and 6 to 9 (POST1) and 12 to 18 months (POST2) after surgery. Acoustic rhinometry was used to measure the cross-sectional areas (CSAs) of segments corresponding to the nasal valve (CSA1), anterior portion (CSA2), and posterior portion (CSA3) of the lower turbinate, and the volumes at the nasal valve (V1) and turbinate (V2) regions at cleft and noncleft sides, before and after nasal decongestion with a topical vasoconstrictor. Nasometry was used to evaluate speech nasalance during the reading of a set of sentences containing nasal sounds and other devoid of nasal sounds. At the cleft side, before nasal decongestion, there was a significant increase (P < 0.05) in mean CSA1 and V1 values at POST1 and POST2 compared with PRE. After decongestion, increased values were also observed for CSA2 and V2 at POST2. No significant changes were observed at the noncleft side. Mean nasalance values at PRE, POST1, and POST2 were not different from each other in both oral and nasal sentences. The measurement of CSAs and volumes by acoustic rhinometry revealed that rhinoseptoplasty provided, in most cases analyzed, a significant increase in nasal patency, without concomitant changes in speech resonance, as estimated by nasalance assessment.

Effects of orthopedic rapid maxillary expansion on internal nasal dimensions in children with cleft lip and palate assessed by acoustic rhinometry.

The objective of the current study was to characterize the internal nasal dimensions of children with repaired cleft lip and palate and transverse maxillary deficiency, using acoustic rhinometry and analyze the changes caused by rapid maxillary expansion (RME). A convenience sampling of 19 cleft lip and palate individuals, aged 14 to 18 years, of both sexes, previously submitted to primary surgeries and referred for RME were analyzed prospectively at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil. All patients underwent acoustic rhinometry before installation of the expansor and at 30 and 180 days after the active expansion phase. Nasal cross-sectional areas and volumes corresponding to the nasal valve (CSA1 and V1) and the turbinates (CSA2, CSA3, and V2) regions were determined before and after nasal decongestion. Rapid maxillary expansion led to a statistically significant increase (P < 0.05) in mean CSA1, CSA2, V1, and V2 (without nasal decongestion) and in CSA1 and V1 (with decongestion) in the group as a whole. Individual data analysis showed that 58% of the patients responded positively to RME, with an average increase in CSA1 of 26% (with decongestion), whereas 37% of the patients had no significant change. Only 1 patient (5%) showed a decrease. The findings contribute toward the characterization of nasal deformities determined by the cleft and demonstrate the positive effect RME had on nasal morphophysiology in a significant number of the patients who underwent this procedure.

Nasal cavity geometry of healthy adults assessed using acoustic rhinometry

UNLABELLED Acoustic rhinometry (AR) has been used as a specific test for nasal patency. AIM this study aimed to set the reference values for nasal cavity cross-section geometry in healthy adults through AR. STUDY DESIGN this is a clinical prospective study. MATERIALS AND METHOD thirty volunteers (14 males and 16 females) without signs of nasal obstruction and aged between 18 and 30 years were enrolled in this study. They were assessed before and after being treated topically with a nasal vasoconstrictor drug. Their nasal cross-sectional areas were measured at the three dips of the rhinogram, corresponding respectively to the nasal valve (CSA1), the anterior (CSA2), and the posterior (CSA3) region of the inferior and middle turbinate. RESULTS the mean areas (+/-SD) for 60 nasal cavities before nasal vasoconstriction were: 0.54+/-0.13cm2 (CSA1), 0.98+/-0.31 cm2 (CSA2), and 1.42+/-0.44cm2 (CSA3). After vasoconstriction, the mean values of the three segments analyzed were significantly larger (p<0.05). Gender was not a statistically significant variable. CONCLUSION The nasal cross-sectional areas obtained for adults may be used for control purposes when studying patients with nasal obstruction, in conjunction with the nasal volume values previously reported by our group.

Adult nasal volumes assessed by acoustic rhinometry

UNLABELLED Acoustic rhinometry allows an objective and non-invasive assessment of nasal geometry. AIM The present study aimed at determining the volumes of specific segments of the nasal cavity in healthy adults including the nasopharynx, using acoustic rhinometry. STUDY DESIGN A clinical prospective analysis. CASES AND METHOD Thirty volunteers with no evidence of nasal obstruction, aged 18 to 30 years (14 males and 16 females) were analyzed. Volumes were measured at the nasal valve region (V1), the turbinates (V2), and the nasopharynx (V3), before and after application of a topical nasal vasoconstrictor. RESULTS The mean volumes measured in 60 cavities before nasal decongestion, were: 1.81+/-0.35 cm(3) (V1), 4.02+/-1.41 cm(3) (V2), and 17.52+/-4.44 cm(3) (V3) for males, and 1.58+/-0.25 cm(3) (V1), 3.94+/-1.03 cm(3) (V2), and 17.80+/-2.73 cm(3) (V3) for females. Gender differences were only significant in V1 (p<0.05). After nasal decongestion, the volumes of all the analyzed segments were significantly larger (p<0.05), and the gender differences were significant for V1 and V2. CONCLUSION Volumes of the three segments in adults with no evidence of nasal obstruction may be used as reference values for other studies.

Áreas seccionais nasais de adultos sadios aferidas por rinometria acústica

Acoustic rhinometry (AR) has been used as a specific test for nasal patency. AIM: this study aimed to set the reference values for nasal cavity cross-section geometry in healthy adults through AR. STUDY DESIGN: this is a clinical prospective study. MATERIALS AND METHOD: thirty volunteers (14 males and 16 females) without signs of nasal obstruction and aged between 18 and 30 years were enrolled in this study. They were assessed before and after being treated topically with a nasal vasoconstrictor drug. Their nasal cross-sectional areas were measured at the three dips of the rhinogram, corresponding respectively to the nasal valve (CSA1), the anterior (CSA2), and the posterior (CSA3) region of the inferior and middle turbinate. RESULTS: the mean areas (±SD) for 60 nasal cavities before nasal vasoconstriction were: 0.54±0.13cm2 (CSA1), 0.98±0.31 cm2 (CSA2), and 1.42±0.44cm2 (CSA3). After vasoconstriction, the mean values of the three segments analyzed were significantly larger (p<0.05). Gender was not a statistically significant variable. CONCLUSION: The nasal cross-sectional areas obtained for adults may be used for control purposes when studying patients with nasal obstruction, in conjunction with the nasal volume values previously reported by our group.

Internal nasal dimensions of adults with nasal obstruction.

UNLABELLED Nasal septum deviation (SD) and turbinate hypertrophy (TH) increase the resistance to respiratory airflow and may impair nasal patency. OBJECTIVE To characterize the nasal geometry of individuals with nasal obstruction secondary to SD and/or TH by means of acoustic rhinometry. METHOD This prospective study included 30 adults with complaints of nasal obstruction (NO) and SD + TH (n = 24), SD (n = 5) or TH (n = 1) seen by clinical examination. The cross-sectional areas of the three main dips of the rhinogram (CSA1, CSA2, CSA3), the distance between them and the nostrils (dCSA1, dCSA2, dCSA3), and the volumes of segments 1.0-3.2 cm (V1), 3.3-6.4 cm (V2), and 7.0-12.0 cm (V3) were measured before and after nasal decongestion (DN). For analysis, right and left cross-sectional areas and volumes were added and mean dCSA was calculated. RESULTS Mean values (standard deviation) before ND were: 0.83 ± 0.23 (CSA1), 1.66 ± 0.52 (CSA2), and 2.36 ± 0.77 (CSA3) cm2; 2.19 ± 0.20 (dCSA1), 4.01 ± 0.33 (dCSA2), and 5.85 ± 0.37 (dCSA3) cm; 2.77 ± 0.51 (V1), 6.52 ± 1.99 (V2), and 26.00 ± 9.62 (V3) cm3; all values were lower than laboratory reference values (p < 0.05). ND led to proportionally greater increases of sectional areas and volumes in the NO group, suggesting an associated functional component. Individual analysis revealed 12 cases with normal results despite nasal obstruction. CONCLUSION Most patients with structural nasal obstruction had results suggestive of nasal patency impairment in acoustic rhinometry.

Obstructive Sleep Apnea Following Pharyngeal Flap Surgery for Velopharyngeal Insufficiency: A Prospective Polysomnographic and Aerodynamic Study in Middle-Aged Adults

Objective To compare the frequency and severity of obstructive sleep apnea (OSA) in middle-aged adults who underwent pharyngeal flap surgery for velopharyngeal insufficiency (VPI) with matched subjects who did not undergo pharyngeal flap surgery and to verify the relationship between OSA severity and internal pharyngeal dimensions. Setting National referral care center for cleft lip and palate. Method Prospective study on 42 nonsyndromic subjects with repaired cleft palate with flap (F group, n = 22) and without flap (NF group, n = 20), aged 40 to 58 years. The main outcome measure was the apnea-hypopnea index (AHI), measured by in-lab nocturnal polysomnography (PSG). The OSA-related symptoms were investigated by Pittsburgh, Epworth, and Berlin questionnaires. The nasopharyngeal or velopharyngeal (NP/VP) cross-sectional area was measured by modified anterior rhinomanometry in subgroups of the F (n = 14) and NF (n = 10) groups at rest and during speech. Differences were considered significant at P < .05. Results Questionnaire scores and frequency of self-reported symptoms of snoring, nasal obstruction, and breathing interruptions during sleep did not differ between groups. OSA was diagnosed by PSG in 60% and 77% of the NF and F subjects, respectively. The difference was not significant. No cases of severe OSA were observed. There was no correlation between AHI and NP/VP area. Conclusion A significant number of middle-aged adults with repaired cleft palate had OSA and related symptoms, regardless of the presence of a pharyngeal flap. Results suggest that VPI treatment with a flap may not cause sleep-disordered breathing in the cleft population. Besides advancing age, congenital upper airway abnormalities may be involved.

Rapid Maxillary Expansion Increases Internal Nasal Dimensions of Children With Bilateral Cleft Lip and Palate

Objective The transverse maxillary deficiency frequently observed in patients with cleft lip and palate (CLP) is usually treated by rapid maxillary expansion (RME). Considering that RME causes a significant increase of the internal nasal dimensions in children with unilateral CLP (UCLP), this study aimed to characterize the internal nasal geometry of children with bilateral CLP (BCLP) and transverse maxillary deficiency using acoustic rhinometry. The study also aimed to analyze changes caused by RME. Design Cross-sectional prospective study. Setting Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil. Participants Fifteen children with repaired BCLP of both genders, aged 8 to 15 years, referred for RME, were prospectively analyzed. Interventions Subjects underwent acoustic rhinometry before the expander installation and after the active phase of expansion. Cross-sectional areas (CSA) and volumes (V) of the nasal valve regions (CSA1 and V1) and turbinates (CSA2, CSA3, and V2), were measured after nasal decongestion. Main Outcome Measures In the majority of the subjects, an increase of internal nasal dimensions was observed. Results Percent changes of CSA1, CSA2, CSA3, V1, and V2 were: +25%, +11%, +9%, 20%, and +12%, respectively. Differences were significant for all variables studied, except CSA3 (P < .05). Conclusions RME promotes an increase in the internal nasal dimensions of children with BCLP, suggesting that RME is capable of substantially improving nasal patency in this population.

Escores de nasalância de falantes do Português Brasileiro aos cinco anos de idade

Purpose To determine nasalance scores of Brazilian Portuguese speaking children without evident speech disorders, language delay and orofacial deformities, at age 5 years, and analyze differences between types of speech samples and genders. Methods Twenty children were analyzed, 11 males, age ranging from 4 years and 10 months to 5 years and 11 months. The Nasometer II 6450 (KayPENTAX) was used for nasalance assessment. Speech samples were eight consonant-vowel syllables and one sequence of nine words. The significance of differences between speech samples and genders were assessed by the Tukey test and Mann-Whitney test, respectively, at a significance level of 5%. Results Mean nasalance scores were: /pa/= 10±4%, /pi/= 22±7%, /sa/= 11±5%, /si/= 24±11%, /ma/= 57±11%, /mi/= 73±13%, /la/= 14±9%, /li/= 25±11%, words (pipa, bis, burro, tatu, pilha, cuca, gui, fila, luz)= 20±6%. Nasalance scores of nasal syllables were significantly higher than those of oral syllables (with high or neutral vowels) and nasalance scores of oral syllables with high vowels were significantly higher than those of oral syllables with neutral vowels, for the majority of comparisons. There was no difference between genders. Conclusion Normative nasalance scores for 5-year-old Brazilian children were determined. The methodology can serve as a standard for the early diagnosis of nasality deviations, such as hypernasality observed in cleft palate speech.