European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Peak nasal inspiratory flow in the assessment of patients with severe chronic rhinosinusitis with nasal polyps treated with full house endoscopic sinus surgery: a prospective longitudinal study.
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Pérez-Chacón Paula, Lara-Sánchez Hugo, Tavarez-Rodríguez Juan José, Freijanes-Otero Jorge, Almeida-Branco Mario S, Díaz-Sastre María Ángeles, Vallejo-Valdezate Luis Ángel
Аннотация
BACKGROUND: Peak nasal inspiratory flow (PNIF) is a simple objective measure of nasal patency, but its role in severe chronic rhinosinusitis with nasal polyps (CRSwNP) remains insufficiently defined. This study evaluated the longitudinal behavior of PNIF after full-house endoscopic sinus surgery (ESS) and its relationship with rhinomanometry, acoustic rhinometry and patient-reported outcomes.
METHODOLOGY: Thirty adults with uncontrolled CRSwNP undergoing full-house ESS were prospectively followed at baseline and at 1, 3 and 6 months. PNIF, active anterior rhinomanometry at a reference pressure of 150 Pa, acoustic rhinometry, SNOT-22 and visual analogue scale (VAS) nasal obstruction scores were recorded at each visit. A healthy control group (n = 30) was included for cross-sectional comparison. Longitudinal changes were analyzed using linear mixed-effects models.
RESULTS: PNIF improved significantly over time (F(3,115) = 10.07, p < 0.001), increasing from 125.6 L/min preoperatively to 182.8 L/min at 1 month, 190.7 L/min at 3 months and 203.0 L/min at 6 months. Rhinomanometric resistance decreased significantly in parallel (F(3,83.7) = 16.54, p < 0.001), whereas acoustic rhinometry parameters did not show significant longitudinal change. SNOT-22 and VAS improved markedly after surgery ( p < 0.001). PNIF correlated strongly with nasal flow and inversely with total inspiratory resistance at baseline (r = 0.732 and r=-0.726, p < 0.001, respectively) and remained significantly associated at early postoperative visits. Correlations with PROMs were observed time-dependent. Baseline PNIF was lower in CRSwNP than in controls, while 6-month values exceeded the control mean.
CONCLUSIONS: PNIF is a practical and clinically useful objective test for the assessment of patients with severe CRSwNP. Its longitudinal behavior parallels rhinomanometric improvement and complements PROM-based assessment after Full House ESS.
METHODOLOGY: Thirty adults with uncontrolled CRSwNP undergoing full-house ESS were prospectively followed at baseline and at 1, 3 and 6 months. PNIF, active anterior rhinomanometry at a reference pressure of 150 Pa, acoustic rhinometry, SNOT-22 and visual analogue scale (VAS) nasal obstruction scores were recorded at each visit. A healthy control group (n = 30) was included for cross-sectional comparison. Longitudinal changes were analyzed using linear mixed-effects models.
RESULTS: PNIF improved significantly over time (F(3,115) = 10.07, p < 0.001), increasing from 125.6 L/min preoperatively to 182.8 L/min at 1 month, 190.7 L/min at 3 months and 203.0 L/min at 6 months. Rhinomanometric resistance decreased significantly in parallel (F(3,83.7) = 16.54, p < 0.001), whereas acoustic rhinometry parameters did not show significant longitudinal change. SNOT-22 and VAS improved markedly after surgery ( p < 0.001). PNIF correlated strongly with nasal flow and inversely with total inspiratory resistance at baseline (r = 0.732 and r=-0.726, p < 0.001, respectively) and remained significantly associated at early postoperative visits. Correlations with PROMs were observed time-dependent. Baseline PNIF was lower in CRSwNP than in controls, while 6-month values exceeded the control mean.
CONCLUSIONS: PNIF is a practical and clinically useful objective test for the assessment of patients with severe CRSwNP. Its longitudinal behavior parallels rhinomanometric improvement and complements PROM-based assessment after Full House ESS.