Objective measurements differ for perception of left and right nasal obstruction

Objective: Nasal obstruction is one of the most common sensation complaints of nasal disease in clinical practice. It is a subjective sensation of nasal airflow. Objective assessment of nasal patency and nasal physiology includes the use of rhinomanometry and acoustic rhinometry. The perception of nasal obstruction changes as the alternating of nasal airway resistance and nasal airflow. However, there were limited studies reported whether the perceptions of the left and right nostrils are similar. We examined the relationship between subjective and objective parameters of the nasal airway in the left and right nostrils. Methods: A prospective study of 101 patients with a deviated nasal septum and chronic hypertrophic rhinitis was conducted for subjective and objective nasal airway evaluation. Patients were then divided into three groups based on the visual analog scale. Associations between measures were evaluated with analysis of variance, f tests and simple regression. Results: Among three patient groups with different subjective sensations of nasal obstruction, there were significant differences among three patient groups according to the objective measurements of airflow resistance on the right side (p= 0.0002 for inspiration right mean resistance; p= 0.0049 for expiration right mean resistance), and for the minimal cross-sectional area (p= 0.030) and nasal cavity volume (p= 0.028 for 0-3.3. cm left nostril; p= 0.047 for 2-4. cm left nostril) on the left side. This indicates that nasal flow resistance is an important determinant for right side nasal obstruction. Nasal minimal cross-sectional area and nasal cavity volume are an important determinant for left side nasal obstruction. Conclusion: Our study indicates the important role of rhinomanometry in objective measurement of right side nasal obstruction and acoustic rhinometry in objective measurement of left side nasal obstruction. Thus, human perception of right and left nostrils may be different and requires further study.