Nagehan ERDOĞMUŞ KÜÇÜKCAN, Leman VEZİROĞLU BİRDANE

Total Nasal Airway Resistance With Different Head Positions in Allergic Rhinitis Patients: A Four-Phase Rhinomanometric Study

Objective: To investigate the changes in nasal airway patency with different head positions in patients with allergic rhinitis (AR). Methods: A total of 30 patients diagnosed with AR were included. The patients were asked to stand upright (temperature, 22-24°C; humidity, 40-70%), to lie down at an angle of 45° from the horizontal position, and to lie down in a supine position, maintaining each position for 20 minutes. A four-phase rhinomanometric (4PR) evaluation was performed on them in these 3 body positions. The effective and vertex resistances during inspiration and expiration were evaluated utilizing HRR2 4PR (RhinoLab GmbH, Hamburg, Germany). Results: There was a significant decrease in nasal resistance and an obvious increase in nasal conductance with the alteration from the supine to the 45° inclined position (P < .05). There were noteworthy differences in the 4PR scores between the standing and supine positions and the supine and 45° inclined positions (P < .05). In contrast, no remarkable differences were detected in the 4PR scores between the standing and 45° inclined positions (P > .05). Conclusion: Our results showed that head elevation impacts nasal resistance and airflow conductance in patients with AR. Objective measures of nasal obstruction are more evident in the supine position than in the standing and 45° inclined positions. These findings might enable some practical recommendations which our patients can follow to relieve their nasal obstruction caused by AR.

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1. Turner PJ, Kemp AS. Allergic rhinitis in children. J Paediatr Child Health. 2012;48(4):302-310. [CrossRef]
2. Gelfand EW. Inflammatory mediators in allergic rhinitis. J Allergy Clin Immunol. 2004;114(5)(suppl):S135-S138. [CrossRef]
3. Bousquet J, Neukirch F, Bousquet PJ, et al. Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol. 2006;117(1):158-162. [CrossRef]
4. McEvoy RD, Sharp DJ, Thornton AT. The effects of posture on obstructive sleep apnea. Am Rev Respir Dis. 1986;133(4):662-666. [CrossRef]
5. Karlsson A, Persson M, Mjörnheim AC, Gudnadottir G, Hellgren J. Total nasal airway resistance while sitting predicts airway collapse when lying down. J Laryngol Otol. 2020;134(10):1-8. [CrossRef]
6. Fouke JM, Jackson AC. Acoustic rhinometry: effects of decongestants and posture on nasal patency. J Lab Clin Med. 1992;119(4):371-376.
7. Hellgren J, Yee BJ, Dungan G, Grunstein RR. Altered positional regulation of nasal patency in patients with obstructive sleep apnoea syndrome. Eur Arch Otorhinolaryngol. 2009;266(1):83-87. [CrossRef]
8. Vogt K, Jalowayski AA, Althaus W, et al. 4-Phase-rhinomanometry (4PR): Basics and practice 2010. Rhinol Suppl. 2010;21:1-50.
9. Stewart MG, Smith TL, Weaver EM, et al. Outcomes after nasal septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg. 2004;130(3):283- 290. [CrossRef]
10. Roithmann R, Demeneghi P, Faggiano R, Cury A. Effects of posture change on nasal patency. Braz J Otorhinolaryngol. 2005;71(4):478- 484. [CrossRef]
11. Rundcrantz H. Postural variations of nasal patency. Acta Otolaryngol. 1969;68(5):435-443. [CrossRef]