Position paper on nasal obstruction: evaluation and treatment.

Position paper on nasal obstruction: evaluation and treatment.

J Investig Allergol Clin Immunol. 2018 Jan 18;:0

Authors: Valero A, Navarro AM, Del Cuvillo A, Alobid I, Benito JR, Colás C, de Los Santos G, Fernández Liesa R, García-Lliberós A, González-Pérez R, Izquierdo-Domínguez A, Jurado-Ramos A, Lluch-Bernal MM, Montserrat Gili JR, Mullol J, Puiggròs Casas A, Sánchez-Hernández MC, Vega F, Villacampa JM, Armengot-Carceller M, Dordal MT, SEAIC Rhinoconjunctivitis Committee & SEORL Rhinology, Allergy and Skull Base Comission

Abstract
Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care, and it may affect up to 30-40% of the population. It affects the quality of life (it especially disturbs sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors; these may be anatomical, inflammatory, neurological, hormonal, functional, environmental or medicinal in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analogue scale, symptom score, standardised questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation amongst the results, they may be considered complementary and not exclusive. Assessing the impact on the quality of life through questionnaires standardised according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the aetiology is inflammatory or functional. Surgical treatment may be necessary when medical treatment fails, to complement or improve it or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary.

PMID: 29345622 [PubMed - as supplied by publisher]

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