Objective To discuss the significance of acoustic rhinometry and rhinomanometry (RM) in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate,and the correlations between the subject symptoms and the object results by acoustic rhinometry and RM in patients before and after operation.Methods A prospective study was conducted in forty-eight patients with nasal septal deviation and/or inferior turbinate hypertrophy.The patients were treated by submucous correction of nasal septum and/or submucous resection of inferior turbinate according to the patients' conditions.Visual analogue scale (VAS) was used to estimate the degree of nasal obstruction.Acoustic rhinometry and RM were used to obtain the data of nasal inspiratory effective resistance (IER),nasal expiratory effective resistance (EER),0 -5 cm nasal cavity volume (0 -5 cm NCV),nasal minimal cross-sectional area (NMCA) and distance of the minimal cross-sectional area to the nostril (DCAN).The data were used to assess the airflow function of nasal cavity.Each patient was tested at the time both before and 4 weeks after surgery.The pre-and post operative data were used to calculate paired t-test by SPSS 17.0 and to disclose the Spearman rank correlation between VAS and IER,EER,0 - 5 cm NCV,NMCA and DCAN individually.Results The preoperative data showed that VAS was (3.44 ± 1.22),nasal IER was (0.66 ±0.27)kPa · s · L-1,nasal EER was (0.68 ±0.29)kPa · s · L-1,0 -5 cm NCV was (3.98 ±1.30) cm3,NMCA was (0.37 ± 0.23 ) cm2 and DCAN was (2.42 ± 0.34) cm ; and the postoperative data showed thatVAS was (1.20 ±0.80),nasal IER was (0.44 ±0.21) kPa · s · L-1,nasal EER was (0.46 ±0.23) kPa · s · L-1,0 -5 cm NCV was (4.85 ± 1.40) cm3,NMCA was (0.53 ±0.44) cm2 and DCAN was (2.25 ±0.49) cm.Significant differences existed in VAS,nasal IER,EER,0 -5 cm NCV,NMCA and DCAN between pre-and post operative data ( t value were 9.163,4.995,4.508, - 4.204,- 2.203,2.924,all P ＜ 0.05 ).The correlation coefficient between VAS and IER,EER and 0 - 5 cm NMCA was 0.386,0.343 and - 0.307,respectively ( all P ＜ 0.05 ). Conclusion Both acoustic rhinometry and RM are appropriate methods to be used in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate,however,the correlations between the subject symptoms and the object results by acoustic rhinometry and RM need further research.%目的 探讨鼻声反射测量法( acoustic rhinometry)及鼻阻力测压法(rhinomanometry,RM)这2种鼻阻力客观检查法在鼻中隔黏膜下成形术及下鼻甲黏骨膜下切除手术疗效中的应用价值以及手术前后患者主观症状与客观检查结果的相关性.方法 采用前瞻性研究设计,选取48例鼻中隔偏曲和(或)下鼻甲肥大的患者,共96侧鼻腔,依据患者病情行相应的鼻中隔黏膜下成形术和(或)下鼻甲黏骨膜下切除术.采用视觉模拟量表(visual analogous scale,VAS)对病变鼻腔进行鼻塞主观症状严重程度的评价,并应用鼻阻力测压法及鼻声反射测量法检查获取鼻吸气相有效阻力(inspiratory effective resistance,IER)、鼻呼气相有效阻力(expiratory effective resitance,EER)、0～5 cm鼻腔容积(0～5 cm nasal cavity volume,0～5 cm NCV)、鼻腔最小横截面积(nasal minimal crosssectional area,NMCA)及鼻腔最小横截面到前鼻孔的距离(distance of the minimal cross-sectional area to the nostril,DCAN)等空气动力学及鼻腔形态学资料,作为对鼻通气功能的评价指标.分别于术前及术后4周时采集资料.将术前及术后的检查数据进行配对t检验,然后用Spearman秩相关对手术前后的VAS评分与各客观检查结果进行相关性分析.结果 术前VAS、IER、EER、0～5 cm NCV、NMCA和DCAN平均((x)±s,下同)分别为(3.44±1.22)分、(0.66±0.27) kPa·s·L-1、(0.68±0.29) kPa· s·L-1、(3.98±1.30) cm3、(0.37±0.23)cm2和(2.42±0.34) cm,术后以上各指标分别为(1.20±0.80)分、(0.44±0.21) kPa· s· L-1、(0.46±0.23) kPa· s· L-1、(4.85±1.40) cm3、(0.53±0.44) cm2和(2.25±0.49)cm,手术前后比较,差异有统计学意义(t值分别为9.163、4.995、4.508、-4.204、- 2.203、2.924,P值均＜0.05).手术前后VAS与IER、EER、0 ～5 cm NCV呈相关趋势(r值分别为0.386、0.343、-0.307,P值均＜0.05).结论 鼻声反射和鼻阻力检查是客观评估鼻中隔黏膜下成形术及下鼻甲骨黏骨膜下切除术的良好指标,但手术前后患者主观症状与客观检查结果的相关性有待进一步研究.
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