Peak Nasal Inspiratory Flow Correlates with Quality of Life in Functional Endoscopic Sinus Surgery

Abstract

Objectives

Whilst nasal function and airflow improve subjectively following functional endoscopic sinus surgery (FESS), a clinically useful and objective tool for quantifying such improvement is lacking. The peak nasal inspiratory flow (PNIF) meter offers convenient and objective measures of nasal patency. However, it has not yet been established whether changes in PNIF after surgery reflect changes in subjective disease burden. In this study we aimed to determine whether changes in PNIF correlate with commonly used subjective symptom and quality of life outcome measures following FESS for chronic rhinosinusitis (CRS).

Design

Prospective cohort.

Setting

Royal National Throat Nose and Ear Hospital.

Participants

Thirty-seven patients undergoing FESS for CRS, with or without polyps (21 male, mean age 48.8).

Main Outcome Measures

PNIF, 'SNOT-22′, 'NOSE' and 'VAS' questionnaires were performed before and after surgery.

Results

In all patients, there was a strong negative correlation between change in PNIF and change in 'SNOT-22′ score following surgery (Pearson r=-0.64, p<0.0001). Strong negative correlations were also seen during subgroup analysis of patients with and without polyps (r=-0.57, p=0.006 and r=-0.67, p=0.005 respectively). Change in PNIF correlated significantly with change in 'NOSE' score following surgery in all patients and those without polyps (r = -0.54, p = 0.0005 and r = -0.68, p = 0.003). There were no significant correlations between PNIF and VAS (nasal obstruction).

Conclusions

Changes in PNIF after FESS appear to best reflect improvements in quality of life in CRS as measured using the 'SNOT-22′ questionnaire.

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