The Journal of Craniofacial Surgery



Volume 26, Number 4, June 2015

The Relation Between Body Mass Index and Nasal Airflow Mehmet Go¨khan Demir, MD, and Hu¨seyin Baki Yilmaz, MD Background: Nasal obstruction and complaints are common attendance causes in otorhinolaryngology clinics. Obese patients are especially more vulnerable for these complaints. There is not enough data about nasal resistance and weight. Patients and Methods: One hundred ten patients who had no nasal complaint and nasal pathology were investigated by peak nasal inspiratory flow meter, nasal symptom evaluation scale (NOSE), and visual analog scale (VAS) calculation. Results: According to the statistical analyses among the BMI groups, there is no significant difference detected. Peak nasal inspiratory flow values highly correlated with height. Height correlated with VAS and weight correlated with NOSE scores. VAS score highly correlated with NOSE score. Also, there is a negative statistically significant correlation between BMI and nasal congestion index. Conclusion: All these data show that there is no relation between BMI and nasal resistance, and although the nasal congestion cycle is preserved in all BMI groups, nasal congestion index is decreased when the weight is raised.

Key Words: Nasal resistance, peak nasal inspiratory flow, PNIF, BMI, Obese, nasal congestion index

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asal obstruction and nasal complaints are common reasons for attendance to ENT clinics. Especially obese patients often complain about nasal obstruction especially at night and also in daily life. For this reason, there are lots of studies about nasal resistance in obese patients. However, body mass index change and its relation between nasal airflow are not investigated enough. Peak nasal inspiratory flow (PNIF) is a good tool for these measurements, and in most studies it is proven that their reliability is as precious as acoustic rhinomanometer which is also attributed to the gold standard modality.1 Also, subjective parameters such as the nasal symptom evaluation scale (NOSE) and a nasal obstruction visual analog scale (VAS) can be used as a nasal obstruction level, and these tests were validated.2 The present study shows the nasal airflow changes among various body mass index groups who had normal nasal anatomy. Another aim of this research is to determine if there is any difference in response of the nasal airway after application of a topical nasal decongestant in different body mass indexes. From the ENT department, Prof. Dr. Celal Ertug˘ Etimesgut State Hospital, Ankara, Turkey. Received September 6, 2014. Accepted for publication January 21, 2015. Address correspondence and reprint requests to Mehmet Go¨khan Demir, MD, Umit mah. Meksika cad. Defne 9 sitesi No:3/21 C¸ankaya, Ankara, Turkey; E-mail: [email protected] The authors report no conflicts of interest. Copyright # 2015 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000001613 #

2015 Mutaz B. Habal, MD

Brief Clinical Studies

PATIENTS AND METHODS A cross-sectional study was applied on 110 adult (18–67 years old) patients who were totally volunteer and referred to the ENT clinic without nasal complaint. All the participants are told about the procedure. After taking the informed consent for the procedure, all the participants were weighed and their heights were measured. According to this data, body mass indexes were calculated and grouped according to the body mass index guideline of the World Health Organization (WHO). After that, patients were examined by flexible nasopharyngoscopy to confirm the absence of nasal pathology. If any nasal pathology such as sinusitis, nasal polyps, septal deviation, and allergic rhinitis were detected, patients were excluded from the study. Each participant filled the NOSE and VAS. A 100 mm VAS anchored by descriptors nose feels extremely clear (0 mm) and nose feels extremely blocked (100 mm) was used to assess the sensation of nasal airflow. Also, NOSE is based on 5 questions, each rated on an ordinal scale from 0 to 4 and is scored on a scale from 0 to 100. After suitable patients were selected, PNIF measurements were done. The PNIF was measured by using an incheck portable nasal inspiratory flow meter (Clement Clarke International, Harlow, UK). For the measurement, each patient held the flow meter mask attachment over the nose and mouth and produced an airtight seal. Then patients inspired as forceful as possible when their lips are firmly closed. Three consecutive recordings were measured and noted. Five minutes later, the patient’s nasal mucosa was decongested by oxymetolazine for each nasal cavity by hand pump. Five minutes later, 3 consecutive PNIF measurements were repeated and all the data recorded. According to the PNIF (PNIFb, PNIF before decongestion; PNIFd, PNIF after decongestion) results, nasal congestion index (NCI) can also be calculated by this formula: NCI ¼ (PNIFd  PNIFb)/PNIFb The study was approved by the Dr. Lu¨tfi Kirdar Kartal Training and Research Hospital Bioethics Committee. All data were expressed as mean and median with minimum and maximum values. Pearson and Spearman correlations were used to investigate the association between BMI, height, weight, PNIFb, and PNIFd measurements. Correlation between different PNIF values and NCI values were also investigated. A P value of less than 0.05 was considered statistically significant. All data were analyzed by SPSS 15.0 program.

RESULTS The sample had a mean age of 42.4 years (range 18–67) and a mean BMI of 30.05 kg/m2 (range 18.6–54.5); 58.18% of the patients were female (Table 1). The groups are divided according to the WHO scale for the BMI. There is no patient in the BMI

The Relation Between Body Mass Index and Nasal Airflow.

Nasal obstruction and complaints are common attendance causes in otorhinolaryngology clinics. Obese patients are especially more vulnerable for these ...
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