What is acoustic rhinomanometry?

Updated: Jul 13, 2021
  • Author: Samuel J Lin, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Acoustic rhinomanometry serves as a diagnostic tool that, based on the analysis of a sound pulse generated into the nasal passages, quantifiably measures the length and area of the nasal cavity. The sound reflected from the nasal airway is transformed into an area-distance plot. The average distance of maximum constriction is within 2 cm. [9] Hilberg in 1989 and Grymer in 1991 demonstrated that cross-sectional area measurements correlated well with radiologic measurements of nasal airway constriction. [23, 24]

Acoustic rhinomanometry has been considered more accurate near the nasal valve area than areas more posterior in the nasal passage. [25] One advantage of acoustic rhinomanometry is that it provides measures of cross-sectional area along the length of the nasal passage. In contrast, rhinomanometry is based on measurements of the narrowest segment of airway. The normal average minimum cross-sectional area is 0.7 cm2 and ranges from 0.3-1.2 cm2. With decongestion, the average cross-sectional area may increase to 0.9 cm2. [1] Using acoustic rhinomanometry, the average distance from the naris to the anterior portion of the inferior turbinate is 3.3 cm, and the average distance from the naris to the posterior portion is 6.4 cm. [9]

The main use of acoustic rhinomanometry is its ability to localize areas of constriction. However, technical challenges exist. Malpositioning of the nasal tube can lead to distortion. Essentially, conventional rhinomanometry determines nasal patency, or an individual's ability to breathe. Acoustic rhinomanometry may be used for states of changing musculovascular conditions or changes in nasal valve dimensions. [9] However, the clinical usage of acoustic rhinomanometry remains guarded. Tomkinson and Eccles stated that the amount of change in cross-sectional area compared with decongestants did not correlate with change in symptom scores. [9]

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