© Borgis - New Medicine 3/1999, s. 4-5
Maria Bączek, Elżbieta Hassmann-Poznańska
Nasal airway dimensions in children, measured by acoustic rhinometry
Department of Pediatric Otorhinolaryngology, Medical University of Białystok, Poland
Head of Dept.: Prof. Elżbieta Hassmann-Poznańska, M.D.
Summary
The aim of the study was assessment of nasal patency and determination of age related normal values of MCA and TMCA in children.
Forty-two healthy children age 0-15 years were examined. In the group of neonates MCA was below 0.1 cm. In the 3-15 year group minimal cross - sectional area at on the level of the head of the inferior concha. All examined parameters showed continuous growth with age.
Acoustic rhinometry is a useful method of assessing nasal patency in children.
Acoustic rhinometry is a new non-invasive method of measuring the patency of the nasal airway. The nasal geometry is assessed by comparison of an acoustic signal with its reflection from within the nose. The technigue is easy to perform and requires little cooperation from the patient. Measurements by acoustic rhinometry are highly reproducible.
The aim of the present study was to evaluate the feasibility and reproducibility of acoustic rhinometry in children, as well as to present normal values for the minimal cross-sectional area and nasal cavity volume in different age groups.
Materials and methods
A total of 42 children aged between 0 and 15 years were examined. The children were divided into three age groups
I - age 0-1 year - 10 children
II - age 5-10 years - 19 children
III - age 10-15 years - 13 children.
All subjects were evaluated using endoscopic examination to exclude the presence of abnormal nasal patency due to rhinitis, adenoidal hypertrophy, or a deviated septum.
Nasal patency was assessed using a wide-band noise rhinometer RHIN 2000/2001 (RhinoMetrics A/S, Lynge Denmark).
In group I a miniprobe and in groups II and III a standard tube, were used.
The examinations were carried out according to the standardized procedure proposed by Tomkinson and Eccles (5).
Results
In order to simplify the analysis the following dimensions were calculated;
Group I
MCAR - minimal cross-sectional area, right side
MCAL - minimal cross-sectional area, left side
TMCA - total minimal cross-sectional area
DMCA - distance from the nostril to the MCA
TVOL45 - total volume of the anterior 45 mm of the -nasal airway.
Groups II and III
MCA1R - cross-sectional area of the first minimum, -right side
MCA1L - cross-sectional area of the first minimum, -left side
TMCA1 - total cross-sectional area of the first minimum,
DMCA1 - distance from the nostril to the MCA1
MCA2R - cross-sectional area of the second minimum, -right side
MCA2L - cross-sectional area of the second minimum, -left side
DMCA2 - distance from the nostril to the MCA2
TVOL60 - total volume of the anterior 60 mm of the -nasal airway.
Rhinometric curves obtained from the infants by means of the miniprobe revealed only one minimum localized 0,63 ą 0,19 mm from the nostrils. The results of measurements are presented in table 1.
Table 1. Rhinometric values from the children in group I. Values given as mean ±SD with range in parentheses.
MCAR (cm2)
MCAL (cm2)
TMCA (cm2)
DMCA (cm) | 0.09 ?
0.02 (0.03-0.15)
0.09 ? 0.02 (0.07-0.11)
0.18 ? 0.04 (0.10-0.26)
0.63 ? 0.19 (0.22-1.04) |
| TVOL 45 (cm3) | 2.28 ± 0.49
(1.19-3.31) |
Rhinometric curves obtained from children in groups II and III revealed two well-separated minima corresponding to the internal orifice and the anterior end of the inferior concha, like those observed in adults. The distance from the nostril to the minima increased with age.The measurement results obtained in group II are presented in table II and in group III in table III.
Table 2. Rhinometric values from children in group II. Values given as mean ±
SD with range in parentheses.
| | MCA1 | MCA2 |
MCAR (cm2)
MCAL (cm2)
TMCA (cm2)
DMCA (cm) | 0.39 ± 0.14
(0.12-0.72)
0.39 ± 0.12
(0.09-0.60)
0.78 ± 0.26
(0.21-1.32)
0.79 ± 0.11 (0.61-1.15) | 0.34 ± 0.13
(0.13-0.79)
0.29 ± 0.12
(0.14-0.81)
0.63 ± 0.25
(0.27-1.60)
1.90 ± 0.24 (1.42-2.85) |
| TVOL 60 (cm3) | 9.03 ± 2.25
(5.48-15.54) | |
Table 3. Rhinometric values from children in group III. Values given as mean ± SD with range in parentheses.
| | MCA1 | MCA2 |
MCAR (cm2)
MCAL (cm2)
TMCA (cm2)
DMCA (cm) | 0.53 ± 0.16
(0.18-0.91)
0.39 ± 0.18
(0.10-0.83)
0.92 ± 0.34
(0.28-1.74)
0.69 ± 0.14
(0.37-0.99) | 0.34 ± 0.11
(0.17-0.61)
0.36 ± 0.10
(0.12-0.56)
0.70 ± 0.21
(0.29-1.17)
2.09 ± 0.17
(1.70-2.53) |
| TVOL 60 (cm3) | 9.65 ± 2.07
(5.56-14.68) | |
Acoustic rhinometry measurements in children are not very numerous (4). So far very few papers about normal values for acoustic rhinometry in healthy children in various age groups have been published (4).
Introduction of the miniprobe in acoustic rhinometry allows measurements in infants.
The rhinometric curves and values (MCA, TVOL45) obtained from infants in our study show a high correlation with the results of Djupesland at al. (1, 2).
The results obtained in group II (children aged 5-10) were similar to the results of Riechelmann et al. (3) in a group of children aged 3-6 years. All examined parameters increased with age.
In groups II and III the minimal cross-sectional area of the nasal cavity coincided with the second minimum that mean with the level of the anterior end of the inferior concha. In contrast, rhinometric examinations of nasal geometry in adults show that the narrowest point in the nose is at the level of the first minimum corresponding to the internal orifice.
Riechelmann et al. (3) found that the minimal cross-sectional area coincided with the first minimum in 14 and with the second minimum in 21 of the 35 children.
Acoustic rhinometry is a valuable method of assessing the geometry of the nasal cavity in children in whom other methods of examination may be very difficult to perform. The present study showed that the examination was well tolerated by the children.
Piśmiennictwo
1. Djupesland P.G., Lyholm B.: Nasal airway dimensions in term neonates measured by continuous wide-band noise acoustic rhinometry. Acta Otolaryngol (Stockh), 1997, 424. 2. Djupesland P.G., et al.: Acoustic rhinometry in the evaluation of congenital choanal malformations. Int. J. Pediatr. Otorhinolaryngol, 1997, 41:319. 3. Riechelmann H., et al.: Acoustic rhinometry in pre-school children. Clin. Otolaryngol, 1993, 18:272. 4. Samoliński B.: Analiza wyników rynometrii akustycznej na potrzeby diagnostyki rynoalergologicznej. Praca habilitacyjna z Katedry i Kliniki AM w Warszawie, 1998. 5. Tomkinson A. Eccles R.: Acoustic rhinometry: do we need a standardized operating procedure? Clin. Otolaryngol 1996, 21:284-287.
