Objective measures of nasal function

Numerous techniques to objectively measure nasal function are available to the rhinologic surgeon. Rhinomanometry, acoustic rhinometry, laser Doppler flowmetry, saccharin transport time, determination of ciliary beat frequency, and olfactory and trigeminal event-related potentials are all techniques in current use. Rhinomanometry is the standard clinical tool used to indicate those patients complaining of nasal obstruction who are likely to benefit from septal and turbinate surgery. Acoustic rhinometry permits the precise localization of nasal stenoses and is the best predictor of a patient's postoperative satisfaction. It is, in addition, more sensitive than rhinomanometry in recording changes of mucosal swelling. Laser Doppler flowmetry, a technique to determine mucosal blood flow, is mainly used to study nasal pathophysiology and mucosal reactions to drug effects. The measuring of saccharin transport time has been found to be an easy and sufficiently reliable test of mucociliary transport. The evaluation of ciliary beat frequency adds further information and helps to distinguish between primary and secondary ciliary dyskinesia. Analysis of nasal secretions helps the rhinologist to understand the pathophysiology of the inflamed airway. Additionally, it opens the door to the development of new therapeutic modalities as our knowledge grows. Olfactory and trigeminal event-related potentials and event-related magnetic fields are newer techniques in use to objectively evaluate olfactory nerve capabilities.