Rhinomanometer and Rhinomanometry Guide

Rinomanometre

15-PAGE PATIENT INFORMATION GUIDE

Rinomanometre

and Rhinomanometry

Objective measurement of nasal breathing, testing process and

correct understanding of the results

TABLE OF CONTENTS + PAGE DISTRIBUTION PLAN INCLUDED

Who was this guide prepared for?

Patients suffering from nasal congestion, unilateral breathing difficulty or snoring People being evaluated for septum deviation, turbinate enlargement, allergic rhinitis or nasal valve problems Those who want to learn what objective measurement means before/after nose surgery

Important note

Rhinomanometry alone does not make a diagnosis; physician examination, endoscopy, allergy evaluation and It is interpreted together with imaging when necessary.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 1

The guide explains the rhinomanometry device and rhinomanometry test from the patient's perspective;

RHINOMANOMETER GUIDE Contents and Page Distribution Contents and Page Distribution Plan The guide explains the rhinomanometry device and rhinomanometry test from the patient's perspective; clinical team In terms of perspective, it is divided into 15 pages to explain it in a regular flow.

Page Title Content focus

1 Cover Purpose of the guide and target reader

2 Contents Page distribution plan 3 Why is nasal breathing measured? The effect of nasal congestion on quality of life 4 What is a rhinomanometer? Device, test and basic concepts 5 Measurement logic Air flow, pressure difference and resistance 6 Pre-test preparation Patient preparation and attention for reliable results

7 How is the test done? Rhinomanometry step by step process 8 Measurement types Active anterior, posterior, passive and 4 phase approach 9 Interpretation of results Resistance, asymmetry and clinical significance 10 In what situations is it used? Deviation, turbinate, allergy, surgical follow-up 11 Advantages and limits Objective data, repeatability and influencing factors

12 Clinical practice flow Examination, measurement, decision and follow-up 13 Treatment follow-up Surgery, medication and patient communication 14 Frequently asked questions Short answers from the patient's perspective 15 Checklist and bibliography Preparation list, red flags, sources This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 2

RHINOMANOMETER GUIDE Why is nasal breathing measured?

RHINOMANOMETER GUIDE Why is nasal breathing measured?

• Why is Nasal Breath Measured?

The nose is not just a channel through which air passes. It warms, humidifies and filters the inhaled air; smell It may also have an impact on sleep and sleep quality. A person with nasal congestion sometimes has a true airway It describes the narrowness, sometimes mucosal swelling, or the way airflow is felt. Therefore

The mere expression "my nose is stuffy" does not always indicate the location and degree of stenosis.

Contribution of objective measurement

It supports the complaint with numerical data. Distinguishing between allergy, turbinate enlargement and structural stenosis It shows the difference between the right and left nasal passage. It helps.

Comparing the changes after medication or surgery. The treatment plan is more understandable to the patient makes it easier. allows sharing.

Not alone, but together with the examination findings

is evaluated.

Nasal congestion may not have a single cause

Structural causes: septum deviation, nasal valve stenosis, post-traumatic deformity, polyp or kitle etkisi.

Mucosal causes: allergic rhinitis, infection, chronic rhinosinusitis, turbinate enlargement or environmental swelling due to irritants.

Functional/felt congestion: nasal loop, airflow turbulence, mucosal dryness, or sinus induced feeling of fullness.

Temel fikir

Rhinomanometry evaluates the feeling of obstruction described by the patient through the relationship "pressure - airflow - resistance" digitizes. This data supports the treatment decision; But it alone does not mean a decision for surgery.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 3

RHINOMANOMETER GUIDE What is a rhinomanometer?

RHINOMANOMETER GUIDE What is a rhinomanometer?

• Rinomanometre Nedir?

Rhinomanometer measures the air flow and pressure difference that occurs during nasal breathing and measures nasal air It is a medical measuring device used to calculate road resistance. The test performed with this device is called "rhinomanometry" It is called. Although the names device and test are sometimes used interchangeably in everyday language, technically

Rhinomanometry is the device and rhinomanometry is the measurement method.

Airflow Pressure difference Resistance

The amount of air passing through the nose. Nasal entrance and back section. Formed against air passage

difference between difficulty

Basic parts of the device

Face mask or nose adapter: used to reduce air leakage during measurement.

Pressure sensor: detects the pressure difference created by the air passing through the nose.

Flow sensor: measures the amount of air passing during breathing.

Software display: shows measurements as graphs and numerical values; allows right/left side comparison verir.

Rhinomanometry - acoustic rhinometry difference

While acoustic rhinometry provides anatomical information about the cross-sectional area and volume of the nasal cavity, rhinomanometry determines the pressure-flow relationship that occurs during breathing, that is, the functional transition evaluates.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 4

RHINOMANOMETER GUIDE Measurement logic

RHINOMANOMETER GUIDE Measurement logic

• Measurement Logic: Pressure, Current and Resistance

When breathing through the nose, air passes through narrow areas. As the passageway narrows, the same amount of air More pressure difference is required to pass. Rhinomanometry measures this relationship and nasal airway calculates the resistance. When resistance increases, the person often feels that it is more difficult to breathe; but

The feeling of congestion and the measurement value may not always coincide exactly.

Simple expression: In the clinic, the values ​​​​according to the protocol of the device

inspiration, expiration, right/left side and total

can be reported as resistance. Nose resistance = Pressure difference / Airflow

Natural variables affecting measurement

Nasal cycle: it is normal physiological for one side to feel more open or closed than the other during the day bir dalgalanma olabilir.

Mucosal swelling: measurement of allergy, infection, cigarette smoke, perfume, dry air or temperature change etkileyebilir.

Effort and technique: poor fit of the mask, leaky breathing through the mouth, irregular breathing or speech may distort the values.

Position and timing: sitting position, waiting time, and whether or not to apply decongestant raporda belirtilmelidir.

Raporlama notu

In some protocols, measurements are evaluated at a standard reference pressure such as 150 Pa. Device used, Reporting method may vary depending on age group and clinical protocol.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 5

RHINOMANOMETER GUIDE Preparation before the test

RHINOMANOMETER GUIDE Preparation before the test

• Pre-Test Preparation

For a reliable rhinomanometry result, it is important to prepare the patient for the test. Preparation, measurement It makes it more repeatable and prevents false high or low resistance values.

Clinics may set additional rules according to their own protocol.

Things the patient should pay attention to

Immediately before the test, intense exercise, hot drinks, smoking or other nasal irritants Avoid apps.

Consult your doctor about any nasal sprays, allergy medications, decongestants, blood thinners or regular medications you use bildirin.

If there is a nose surgery, nosebleed, infection, fever or new trauma, be sure to say it.

During the test, one nostril may be closed briefly for measurement; calmly and without panicking It is necessary to breathe regularly.

Teste uygun durumlar Erteleme gerekebilecek durumlar

If you can breathe calmly Active nosebleed

If the mask/adapter is tolerable Severe upper respiratory tract infection If the medication schedule determined by the physician is followed. Recent nasal trauma or surgery

early period after

Warning about medications

The decision to stop medication or use decongestants should not be made by the patient alone. Who wants the test The instructions of the physician or clinic should be taken as basis.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 6

RHINOMANOMETER GUIDE How is the test done?

RHINOMANOMETER GUIDE How is the test done?

• How is Rhinomanometry Test Done?

The flow below is summarized according to the most commonly used active anterior rhinomanometry logic.

There may be slight differences depending on clinical protocol and device type.

1 A brief preliminary evaluation is made: complaints, surgical history, medications and intranasal condition are noted.

2 The patient sits upright, adapts to the environment for a short time, and the nose can be gently cleaned.

3 The mask is placed on the face or a nose adapter is used; Care should be taken to ensure that there is no air leakage.

4 While one side is being measured, the other nostril can be closed or connected for pressure measurement.

5 The patient breathes normally, calmly, with the mouth closed; The device records pressure and airflow.

6 If necessary, the right and left sides are measured separately, and sometimes again before and after decongestant.

7 Results are reported graphically and as numerical values; It is interpreted together with the examination findings.

Hasta deneyimi

The test is usually painless and does not involve radiation. The most common situation is that the mask fits the face and is short is sustained directed breathing. Do not talk or laugh during the measurement and do not breathe air through your mouth It is important not to miss it.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 7

RHINOMANOMETER GUIDE Measurement types

RHINOMANOMETER GUIDE Measurement types

• Measurement Types

Rhinomanometry can be applied by different methods. The method to be chosen depends on the patient's nasal anatomy, It varies depending on the purpose of measurement, the features of the device and the experience of the clinic.

Method How is it done? Clinical note

Active anterior The patient breathes with his own breath; pressure difference in a nasal passage Most commonly used in daily clinic and the current on the opposite side is evaluated. is one of the methods.

Active posterior The total flow of both nasal passages is measured; pressure mouth Patient compliance is more difficult; can be taken from behind. reflexes may affect the measurement.

Passive anterior Air from the nasal passage under a certain flow or pressure condition In some provocation tests or is passed. Can be used in special protocols.

4-phase rhinomanometry. Dynamic resistance changes during the inspiration and expiration phases of the respiratory cycle.

More detailed records are taken. help with detailed evaluation

eder.

Which method is better?

No single method is absolutely superior for every patient. The aim is to use the appropriate protocol in the appropriate patient is to take repeatable measurements.

The nostril is completely closed, there is a septal perforation, or the mask/adapter fit is difficult Method selection may vary in patients.

The method by which the measurement was made must be stated in the final report; values ​​of different methods should not be compared directly.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 8

RHINOMANOMETER GUIDE Interpretation of results

RHINOMANOMETER GUIDE Interpretation of results

• Interpretation of Results

Rhinomanometry report is generally evaluated on airflow, pressure difference and nasal resistance.

Interpretation depends on the patient's complaint, nasal examination, endoscopic findings, allergy status and previous It should be done together with the treatments.

Headings looked at while reading the report

Right-left difference: Significantly higher resistance on one side than the other, unilateral stenosis or mucosal It may be associated with swelling.

Total nasal resistance: When both passages are evaluated together, it gives an idea about the general nasal aperture.

Separation of inspiration and expiration: Differences in resistance during inhalation and exhalation, dynamic stenosis or may provide clues to a valve problem.

Change after decongestant: Significant improvement after nasal spray does not indicate the contribution of mucosal swelling can make you think; If the improvement is low, structural reasons can be further investigated.

Interpretive logic: clinical integrity, not single value

Complaint Inspection Measurement

Sensation of congestion, snoring, effort, Septum, turbinate, valve, mucosa Resistance, flow, asymmetry

uyku

Patient complaint is important

A low or normal resistance value does not invalidate the patient's complaint. Olfaction, sinus pressure, Mucosal dryness, sleep apnea, or perceptual airflow problems should be evaluated separately.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 9

RHINOMANOMETER GUIDE Areas of use

RHINOMANOMETER GUIDE Areas of use

• In Which Situations Is It Used?

Rhinomanometry is a helpful test in the objective evaluation of nasal congestion. Especially treatment It may be useful to determine the baseline value before treatment and to show the change after treatment.

Septum deviation, turbinate enlargement

Curvature in the middle compartment of the nose right-left air Mucosal or structural growth of the inferior turbinates can create a current difference. It can increase measurement, complaint and nasal resistance. Decongestant Pre/post measurement along with examination contributes to surgical planning.

destekler.

Allergic rhinitis Nasal valve stenosis

Mucosal swelling may change periodically. Collapse in the nose wing or Resistance may increase if there is objective dynamic narrowing in response to treatment or provocation tests; inspection can be monitored by measurement. evaluated together with its maneuvers.

Snoring and its relationship with sleep

Nasal congestion can increase snoring and open-mouth sleeping complaints; but rhinomanometry sleep apnea It is not a diagnostic test. If sleep apnea is suspected, sleep test and relevant expert evaluation must. Rhinomanometry may provide helpful data in understanding the contribution of the nasal passage to sleep complaints.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 10

RHINOMANOMETER GUIDE Advantages and limitations

RHINOMANOMETER GUIDE Advantages and limitations

• Advantages and Limits

Like every medical test, rhinomanometry has its strengths and limitations that need to be considered.

When used correctly, it strengthens clinical judgment; If applied incorrectly, it may give misleading results.

Advantages Limits

It gives numerical and graphical data. Results may be affected by technical application.

It makes left-right comparison easier. It does not show the exact location of the blockage on its own.

It shows the change before and after treatment. There may be a mismatch between the complaint and the measurement.

It is painless and does not involve radiation. Nasal cycle and mucosal status Provides visual data for patient education. It is variable.

Compliance is the same in every age and patient group

It is not.

Why is quality control important?

Device calibration, selection of appropriate mask/adapter and prevention of air leakage determine measurement quality.

If follow-up will be done on the same patient, the same protocol, similar time and similar preparation as possible conditions are preferred.

In the final report, whether decongestant was applied, the measurement method and measurement conditions are clearly belirtilmelidir.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 11

RHINOMANOMETER GUIDE Clinical practice flow

RHINOMANOMETER GUIDE Clinical practice flow

• Clinical Practice Flow

Rhinomanometry is often not a stand-alone method but rather a systematic evaluation of nasal congestion Used as part of the flow. The diagram below makes patient management understandable.

Complaint and story

1 Duration of blockage, side, allergy, snoring, surgery history

KBB muayenesi

2 Septum, turbinate, valve, mucosa, polyp and infection findings

Objective measurement

3 Right-left and total resistance evaluation with rhinomanometry

Gerekli ek testler

4 Endoscopy, allergy testing, imaging or sleep testing

Treatment and follow-up

5 Medication, allergy control, surgery or lifestyle adjustments

Klinik karar

The same resistance value may have different meanings in two patients. What determines the decision; value, complaint, inspection Findings, patient expectations and treatment risks are weighed together.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 12

RHINOMANOMETER GUIDE Treatment follow-up

RHINOMANOMETER GUIDE Treatment follow-up

• Rhinomanometry in Treatment Follow-up

Rhinomanometry is used to record the baseline value before treatment and the objective change after treatment can be used to show. This approach improves patient satisfaction, surgical planning and treatment response.

It may be useful for monitoring.

Usage examples by treatment

Medical treatment: nasal spray and allergy treatment for mucosal swelling caused by allergic rhinitis or turbinates Before/after objective change can be monitored.

Septoplasty or turbinate surgery: measurement before surgery and after healing is complete comparison can be made.

Functional rhinoplasty/nasal valve treatment: examination maneuvers and patient complaints of dynamic stenosis can be evaluated together with their scores.

Patient communication: graphics and numerical values ​​can make it easier for the patient to understand the treatment process; Expectations can be discussed more realistically.

Be careful when comparing before and after

Resistance before treatment

For meaningful interpretation, it is important that the same protocol, appropriate timing, and healing process are completed.

Early and post-treatment edema resistance may temporarily affect the measurement.

Holistic approach in follow-up

Even if there is an improvement in the measurement after the treatment, if the patient's complaints continue, sleep, sinus, allergy, odor Additional causes such as ingestion, mucosal dryness or mouth breathing should be investigated.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 13

RHINOMANOMETER GUIDE Frequently asked questions

RHINOMANOMETER GUIDE Frequently asked questions

• Frequently Asked Questions

Does the test hurt?

No. Rhinomanometry is usually painless. Brief discomfort due to mask or nose adapter hissedilebilir.

Is there radiation?

No. This test does not use imaging that involves radiation, such as x-rays or computed tomography.

If the result is bad, is surgery necessary?

No. The result alone is not a decision for surgery. Examination, complaint, medication response and patient expectation together is evaluated.

Does nasal spray change the outcome?

Yes, some nasal sprays can change the measurement by reducing mucosal swelling. Spray usage should be advised by the physician should be arranged according to the instructions.

Is it used for snoring?

It may be helpful in understanding the contribution of nasal congestion to snoring; However, for the diagnosis of sleep apnea, sleep testi gerekir.

Is it done in children?

It can be applied to cooperative children. The child's ability to remain calm and understand the guidance is measured is important for quality.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 14

RHINOMANOMETER GUIDE Checklist and bibliography

RHINOMANOMETER GUIDE Checklist and bibliography

• Checklist and Bibliography

You can use this page as a short check form when going to an appointment.

Short checklist before rhinomanometry

My history of nose surgery, trauma or bleeding. If the mask does not fit my face properly, notify the technician I will say. I will give.

The nasal sprays and allergy medications I use. The result alone is not a diagnosis.

I will let you know. I know they will be interpreted together.

Do not breathe through your mouth during the test. If I suspect snoring or sleep apnea, also I will work. I will request a sleep evaluation.

Warning signs requiring ENT evaluation

Unilateral and increasing nasal congestion, nosebleeds, foul-smelling discharge or facial pain.

Significant shape change, sudden deterioration in breathing or recurrent bleeding after nasal trauma.

Witnessed respiratory arrest with snoring, excessive daytime sleepiness or morning headache.

References

• Clement P.A.R., Gordts F. Consensus report on acoustic rhinometry and rhinomanometry. Rhinology, 2005;43:169-179.
• Naito K. et al. Objective assessment of nasal obstruction. Auris Nasus Larynx / PMC review, 2022.
• Patil N. et al. Rhinomanometry: A Comprehensive Review of Its Applications and Advances in Rhinology Practice. Cureus

/ PMC, 2024.

• American Rhinologic Society. Nasal Valve Collapse Position Statement, 2026.
• Aetna Clinical Policy Bulletin. Acoustic Rhinometry and Rhinomanometry - overview of objective nasal patency tests.

Text message

The rhinomanometer tells numbers how open the nose is; If the diagnosis is correct, these numbers should be determined by the doctor It is formed by interpretation along with examination.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 15

Rinomanometre

15-PAGE VISUAL PATIENT INFORMATION GUIDE

Rinomanometre

and Rhinomanometry

Objective measurement of nasal breathing, testing process and correct understanding of the results CONTENTS + PAGE DISTRIBUTION PLAN INCLUDED

Nasal airflow Pressure-flow measurement

Pressure - Current

Nasal airway: flow + pressure difference

Who was this guide prepared for?

Patients suffering from nasal congestion, unilateral breathing difficulty or snoring People being evaluated for septum deviation, turbinate enlargement, allergic rhinitis or nasal valve problems Those who want to learn the meaning of objective measurement before/after nose surgery This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 1

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Contents and Page Distribution Plan The guide has been prepared with a 15-page visual flow.

In this version, in addition to the text, appropriate schematic images, device drawings, test flow diagrams and graphs has been added. Images are representative drawings prepared to facilitate patient education.

Kapak

Purpose of the guide and target reader

Contents Page distribution plan

Why is breathing measured through the nose?

Effect of nasal congestion

Rinomanometre nedir?

Device, test and basic concepts

Measurement logic

Air flow, pressure difference, resistance

Pre-test preparation

Patient preparation and attention

How is the test done?

Step by step application

Measurement types

Aktif anterior, posterior, pasif, 4 faz

Interpretation of results

Resistance and right-left asymmetry

In what situations is it used?

Deviasyon, konka, alerji, cerrahi

Advantages and limits

Objective data and influencing factors

Clinical practice flow

Inspection, measurement, decision, follow-up

Treatment follow-up

Before/after comparison

Frequently asked questions

Brief answers from the patient's perspective

Checklist and bibliography

Preparation, red flags, resources

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 2

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Why is Nasal Breath Measured?

Quality of life of nasal congestion and its place in the treatment plan.

Nasal airway: flow + pressure difference

• Why is Nasal Breath Measured?

The nose is not just a channel through which air passes. It warms, humidifies and filters inhaled air. Nasal congestion The feeling of complaint in the patient and the actual airway resistance may not always be at the same level. Therefore objective Measurement supports inspection findings with numerical data.

Contribution of objective measurement Causes of congestion

It supports the complaint with numerical data. Structural: septal deviation, valve stenosis.

It shows the difference between right and left nasal passage. Mucosal: allergy, infection, turbinate enlargement.

Functional to monitor change after medication or surgery: nasal cycle, dryness, turbulence helps. sentimental.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 3

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Rinomanometre Nedir?

Device, test and basic concepts.

Pressure - Current

Rhinomanometer: sensors + software + mask/adapter

• Rinomanometre Nedir?

Rhinomanometer measures the air flow and pressure difference that occurs during nasal breathing and determines the nasal airway It is a medical measuring device used to calculate resistance. The test performed with this device is called rhinomanometry. Technically The device is rhinomanometry and the measurement method is rhinomanometry.

Airflow Pressure difference Resistance

Amount of air passing through the nose Difficulty in air passage between the entrance and the back of the nose

fark

Basic parts of the device

Face mask or nose adapter: used to reduce air leakage.

Pressure and flow sensors: collect data during breathing.

Software display: shows measurements as graphs and numerical values.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 4

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RHINOMANOMETER AND RHINOMANOMETRY GUIDE Page 5/15

Measurement Logic

Airflow, pressure difference and nasal airway resistance.

Pressure

Pressure - Flow Graph

Basic measurement logic

Rhinomanometry during nasal breathing

Measures pressure difference and air flow. Nose

airway resistance is often associated with

It is evaluated as a numerical expression.

Resistance = Pressure difference / Air flow

Flow

lower resistance higher resistance

• Measurement Logic: Current, Pressure and Resistance

Rhinomanometry shows how much air the nose passes at a certain pressure difference. The higher the resistance, the same It may mean that a greater pressure difference is required for breathing or that airflow is lower. Clinic In the evaluation, measurement curves, numerical resistance values ​​and right-left comparison are considered together.

Factors affecting the reliability of the result

The mask fits the face snugly and air does not escape from the edge of the nose.

The patient's calm, rhythmic and natural breathing during the test.

Allergy, infection, use of nasal spray or influence of the nasal cycle at the time of measurement.

Standard implementation of device calibration and measurement protocol.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 5

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Pre-Test Preparation

Attention to patient preparation and reliable outcome.

Preparation APPOINTMENT

Bilgi ver

Burnu temizle

Nasal airway: flow + pressure difference Natural breathing

• Pre-Test Preparation

Preparation is important for the reliability of the measurement. Each center may have its own protocol; therefore before testing The medication, spray or timing rules prescribed by the clinical team should be followed.

Recommended things to do Things to pay attention to

Previous surgery and medication at appointment Recent upper respiratory tract Share your information. Tell us if you have an infection.

Gently blow your nose immediately before the test. Use nasal spray or allergy medication clear it. consult a physician.

Sit calmly, maintain natural breathing rhythm. If there is a mask leak or a feeling of panic, contact the team bildirin.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 6

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How to Test?

Rhinomanometry process step by step.

The patient sits upright; mask leakage is reduced; breathe calmly

• How to Test?

Preparation

The patient sits upright, the test is explained and the device is prepared.

Placement

The mask or nose adapter is positioned so that there is no air leakage.

natural breath

The patient breathes normally through the nose; Coercion is not desired.

Registration

The device records pressure and air flow as graphs/numbers.

Yorum

The results are evaluated together with the examination findings and complaints.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 7

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Measurement Types

Active anterior, posterior, passive and 4 phase approach.

Representative measurement options

Aktif anterior Posterior Pasif 4 faz

• Measurement Types

Rhinomanometry can be applied with different techniques. One of the most frequently heard concepts in current clinical practice is active anterior rhinomanometry. Which method is preferred depends on the center's device, the patient's condition and the physician's may vary depending on the purpose of evaluation.

Featured methods The idea of ​​the 4 phase approach

Active anterior: one nasal side is measured while the other 4 phase rhinomanometry measures inhalation and exhalation curves The pressure of the side is taken as reference. nasal valve behavior and Posterior approach: space for additional interpretation of dynamic changes in both nasal cavities

assessable. can provide. However, routine in every center

may not be used. Passive methods: resistor by giving external current

can focus on calculation.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 8

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Interpretation of Results

Resistance, asymmetry and clinical significance.

Pressure

Curve interpretation Right / Left Comparison

Right nose 62%

Sol burun 34%

Flow

lower resistance higher resistance Difference alone is not diagnostic; It is interpreted by examination.

• Interpretation of Results

In the interpretation of the result, rather than a single number, the patient's complaint, examination findings, right-left difference, inhalation/exhalation curves and, if necessary, the change after decongestant are evaluated together. Resistance height obstruction can support; but nasal cycle, allergy and technical factors may also affect the result.

Expressions that may be encountered in the report

Total nasal resistance: the total difficulty in passing air through the nose.

Unilateral resistance: evaluation of the right and left passage separately.

Asymmetry: one side appearing narrower/more resistant than the other.

Decongestant response: may help understand variability due to mucosal swelling.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 9

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Areas of Use

Deviation, turbinate, allergy and surgical follow-up.

Septum deviation, turbinate enlargement

Structural curvature Mucosal volume increase

Alerjik rinit Cerrahi takip

Swelling and variable congestion Before/after comparison

• In Which Situations Is It Used?

Rhinomanometry is used to objectively evaluate nasal congestion, monitor pre/post-surgical change, or It can be used to track response to medical treatment with supporting data. The decision to use should always be clinical given according to context.

Septum deviation, turbinate enlargement

Helps quantify the effect of curvature on airflow. Insight into mucosal volume increase and decongestant response olabilir. verebilir.

Allergic rhinitis Surgery/medication monitoring

Sharing pre- and post-treatment data with the patient to monitor seasonal or trigger-related variability available. makes it easier.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 10

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Advantages and Limitations

Objective data, repeatability and influencing factors.

Advantage Limit

Objective data is powerful; It gains meaning through clinical interpretation.

• Advantages and Limitations

Advantages Limits

Since the measurement is numerical, before/after treatment It does not make a diagnosis on its own; endoscopy and examination comparison can be made. It is interpreted together with .

The difference between the right and left sides becomes more visible. Mask leakage, stress, nasal spray and nose cycle may affect the outcome. Comprehensible data when discussing the treatment plan with the patient presents. Resistance measured by felt obstruction is always may not overlap exactly. Useful in follow-up with repeatable measurement protocol

it could be. Each device and center use the same reference ranges kullanmayabilir.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 11

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Clinical Practice Flow

Inspection, measurement, decision and follow-up.

Complaint

Nasal congestion, snoring, one-sided breathing difficulty

Muayene

ENT examination, endoscopy and, if necessary, allergy evaluation

Measurement

Quantification of flow-pressure-resistance with rhinomanometry

Karar

Medikal tedavi, cerrahi planlama veya takip

Kontrol

Post-treatment remeasurement and patient feedback

• Clinical Practice Flow

Rhinomanometry is only one part of the clinical decision tree. The physician evaluates the measurement result according to the patient's complaint, intranasal It evaluates the examination findings together with endoscopy, allergy status and treatment goals.

Pratik yorum

If the measurement result supports the patient's complaint, the treatment plan is strengthened. If the measurement is low but the complaint is high, dryness, valve dynamics, sinus disease, or sensory factors are also evaluated.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 12

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RHINOMANOMETER AND RHINOMANOMETRY GUIDE Page 13/15

Treatment Follow-up

Surgery, medication and patient communication.

Change can be monitored after treatment resistance

Follow First

• Rhinomanometry in Treatment Follow-up

Measurements before and after treatment help to numerically show the change in nasal airway resistance.

it could be. This is especially true after septoplasty, turbinate surgery, allergy treatment, or nasal valve procedures.

can strengthen communication.

Questions to ask during follow-up Contribution of measurement

Has the feeling of breathing improved in daily life? Provides numerical comparison before/after treatment.

Decreased sleep, snoring or mouth breathing The change in resistance is noticeable to the patient ? can be shown.

Does unilateral obstruction persist? Indicates the need for additional evaluation if necessary.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 13

RHINOMANOMETER AND RHINOMANOMETRY GUIDE Page 14/15

RHINOMANOMETER AND RHINOMANOMETRY GUIDE Page 14/15

Frequently Asked Questions

Short and understandable answers for the patient.

Does it hurt?

It is usually painless.

How long does it take?

In most centers it is a short test.

Is surgery necessary?

The result alone is not a decision.

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It can be repeated for comparison at follow-up.

• Frequently Asked Questions

The test is usually short and painless. The patient only breathes naturally through the nose. During measurement If discomfort, shortness of breath or mask incompatibility is felt, the clinical team should be informed immediately.

Short message to the patient

Rhinomanometry result: "How much air passes through your nose?" It gives a numerical answer to the question. But treatment The decision is planned not only based on this result, but also on all of your examinations and complaints.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 14

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RHINOMANOMETER AND RHINOMANOMETRY GUIDE Page 15/15

Checklist and Bibliography

Pre-test reminder, red flags and resources.

Preparation

Measurement!

Comment If there is stenosis, resistance may increase

If there is a red flag, consult a physician

Pre-test mini check Red flags

Check appointment time and medication/spray instructions Unilateral new onset and gradually increasing I did. nasal congestion.

Recent infection, allergy or surgery Bleeding, foul-smelling discharge, rapid growth I will share the information. mass feeling.

I will try to breathe naturally during the test. Severe pain, vision or face swelling.

Bibliography and note

Patil N. et al. Rhinomanometry: A Comprehensive Review of Its Principles, Clinical Applications, and Future Directions.

Cureus, 2024.

Naito K. et al. Objective assessment of nasal obstruction. Auris Nasus Larynx / PMC, 2022.

Sunnergren O. et al. Active anterior rhinomanometry: A study on nasal airway resistance. Clinical Otolaryngology, 2023.

Merkle J. et al. Rhinomanometric reference intervals for normal total nasal airflow resistance. Rhinology, 2014.

Images are representative diagrams prepared for patient education purposes; The device and measurement setup may vary depending on the center.

This guide is for informational purposes only; For diagnosis and treatment, an evaluation by an ENT specialist is required. 15