• 제목/요약/키워드: nasal obstruction

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수면호흡장애와 코막힘 (Sleep Disordered Breathing and Nasal Obstruction)

  • 정유삼
    • 수면정신생리
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    • 제12권2호
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    • pp.93-97
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    • 2005
  • Nasal obstruction may cause or aggravate sleep disordered breathing but exact pathogenesis is not clear. The possible mechanism could be combination of alteration in upper airway aerodynaimcs, loss of nasal reflex or sensation, effect of mouth opening, and a genetic predisposition. Anatomical narrowing of nasal airway cause more rapid airflow and induce more negative inspiratory air pressure. So, it increases collapsibility of pharyngeal airway. Loss of nasal sensation to airflow block nasal reflex. Mouth opening decreases the activity of pharyngeal airway dilator muscles and narrowing the pharyngeal airway may occur. The treatment of nasal obstruction should be done according to the cause. The causes of nasal obstruction are various from problems of external nasal opening to nasopharynx. Relief of nasal obstruction may not cure sleep disordered breathing always. In some mild obstructive sleep apnea patients, treatment of nasal obstruction only may cure sleep disordered breathing. In some severe sleep apnea patients, treatment of nasal obstruction may increase compliance of continous nasal positive airway pressure.

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인위적인 비폐색에 의한 비음치의 변화 (The Change of the Nasalance Score following Simulated Nasal Obstruction)

  • 임성은;김현준;최재진;표화영;배정호;김광문;최홍식
    • 대한후두음성언어의학회지
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    • 제11권2호
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    • pp.167-171
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    • 2000
  • Nasal obstruction due to nasal deformities, rhinitis, sinusitis, or nasal polyps etc. induces hyponasality, which can influence the articulation and/or phonation of patients. However few studies were done on the subjects. Therefore, this study was performed to establish the guideline that can be used in diagnosing the hyponasality. We analyzed the nasalance scores of 6 different sentences for 26 normal adults. We measured the nasalance scores before simulated nasal obstruction, after one nostril obstruction, and after both nostrils obstruction, while the subjects are reading roe nasal sentences(so-called, 'Mama' sentence, 'Mimi' sentence, and 'Nana' sentence) and three non-nasal sentences('Papa' sentence, 'Bibi' sentence, and 'Tatda' sentence). The change of nasalance score of six sentences were compared in three conditions, that is, without obstruction, with one nostril obstruction, and with both nostrils obstruction. The nasalance scores of one nostril obstruction and both nostrils obstruction were significantly lower than those of no obstruction. The mean nasalance scores of one nostril obstruction and both nostrils obstruction were lower than those of no obstruction by 10.93% and 48.88% in 'Mama' sentence, 3.72% and 5.76% in 'Papa' sentence, 12.28% nd 38.12% in 'Mimi' sentence, 7.28% and 12.96% in 'Bibi' sentence, 13.32% and 34.62% in 'Nana' sentence, 4.27% and 717% in 'Tatda' sentence, respectively. In both nostrils obstruction, the nasalance score of nasal sentences were decreased more than those of non-nasal sentences significantly. The result suggests that nasal sentences can be used as efficient stimuli in assessing the patients suspected of hyponasality. Eventhough non-nasal sentences also induced significant discrimination, the dynamic range was too small.

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비폐색 부위에 따른 비강자음의 음향학적 특성 및 비음도의 변화 (Acoustic Characteristics of Nasal Consonants and the Change of Nasalance according to the Sites of Nasal Obstruction)

  • 손영익;정유석;이은경;정원호
    • 대한후두음성언어의학회지
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    • 제9권1호
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    • pp.27-31
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    • 1998
  • Nasal sounds include nasalized vowels and consonants. Nasal cavity is important for the acoustics of nasal sounds. Evaluating the effects of site-specific nasal obstruction on nasal sound will help us to understand the importance of nasal geometry for the nasal sound and to foretell voice change after nasal surgery This study was designed to analyze the change of nasality and formant characteristics of nasal sound by obstructing different sites around the ostiomeatal unit(OMU). Ten adult male and female volunteers participated. The nasal formants and bandwidths of nasal consonant /n/ were checked in various conditions of nasal obstruction. The nasalance of rabbit, baby, and mama passages were compared in each conditions. Nasalance of all passages decreased when anterior portion of OMU was obstructed. Center frequency of first nasal formant(NF1) of /n/ has decreased in the order of anterior, inferior obstruction. The bandwidth of NF1 decreased in female with anterior obstruction. Anterior portion of OMU is most critical to the change of nasality and acoustics of nasal consonant. When anterior portion of OMU is obstructed, the shift of NF1 to a lower frequency and the narrowing of NF1 bandwidth are the major acoustic changes of nasal consonant /n/.

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코질환과 수면무호흡증 (Nasal Diseases and Its Impact on Sleep Apnea and Snoring)

  • 김창희;이재서
    • 수면정신생리
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    • 제11권1호
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    • pp.17-21
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    • 2004
  • Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.

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귤피대황박초탕(橘皮大黃朴硝湯)으로 호전된 코막힘을 주소증으로 한 비염 환자 18명에 대한 증례보고 (18 Cases of Rhinitis with Nasal Obstruction Treated by Gyulpidaehwangbakcho-tang)

  • 김난이;조형래;지선영;황보민
    • 한방안이비인후피부과학회지
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    • 제30권3호
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    • pp.193-200
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    • 2017
  • Objectives : This study was carried out to investigate the effect of Gyulpidaehwangbakcho-tang on rhinitis with nasal obstruction. Methods : We treated 18 rhinitis patients with nasal obstruction. We used the Visual Analogue Scale(VAS), and recorded the condition of patients as +++, ++, +, -. Results : After the treatments, all patients VAS of nasal obstruction was remarkably decreased. Conclusions : This study suggests that Gyulpidaehwangbakcho-tang is effective on rhinitis with nasal obstruction.

코막힘으로 인해 양압기에 적응하지 못한 폐쇄성수면무호흡증 환자에서 시행된 코수술 1례 (A Case of Nasal Surgery for a Positive Airway Pressure-Intolerant OSAS Patient Due to Nasal Obstruction)

  • 정재현;선상우;홍승노;최지호
    • 수면정신생리
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    • 제23권2호
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    • pp.97-99
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    • 2016
  • Positive airway pressure (PAP) is currently recommended as a primary treatment for obstructive sleep apnea syndrome (OSAS) and positively affects various subjective and objective parameters related to OSAS, such as the apnea-hypopnea index, excessive daytime sleepiness, and blood pressure. However, PAP also exhibits various adverse effects, including skin breakdown, pressure intolerance, claustrophobia, unintentional mask removal, mouth leaks, and dryness. Especially, unintentional mask removal due to nasal obstruction may result in poor PAP compliance. A 47-year-old male patient with severe OSAS who had low PAP compliance due to nasal obstruction underwent nasal surgery. After the surgery, nasal obstruction was corrected and the patient experienced improved PAP compliance (from 30.4% to 86.7%). This case demonstrates that nasal surgery may be useful for improving PAP compliance in OSAS patients with nasal obstruction.

비염(鼻炎) 환자(患者)에 관(關)한 임상적(臨床的) 관찰(觀察) (A clinical study on the patients with Rhinitis)

  • 이승연;박동일
    • 한국한의학연구원논문집
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    • 제1권1호
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    • pp.335-345
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    • 1995
  • The clinical study was done as apreliminary to treat Rhinitis with orinetal medicine. We analysed 73 patients with sneezing, nasal discharge and nasal obstruction, who had visited Kept. of Internal Medicine. Hospital of Oriental Medicine, Dongui University from Jan, 1, 1993 to Dec, 31, 1993. The result swere obtained as follows. 1. In the sex ratio, man was higher than woman as 2.31:1 and in age distribution, below 10s was the top as 30.14% 2. In duration of hestory, over one year was the top as 64.38% 3. The most complained symptoms were nasal discharge and nasal obstruction as 94.52% 4. In the frequency of treatments, the cooler season was more than the warmer season 5. In the treatments of Medi-acupunctrer, most of acupuncture therapy was oden less than 5 times and Seonotanggami was most rsed in presciptions. 6. In the case of applying to Seonotanggami, nasal discharge was the most relieved symptom.

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Usefulness of nasal cavity evaluation before high-resolution esophageal manometry in high-risk patients

  • Hyun Jin Min;Jae Yong Park
    • The Korean journal of internal medicine
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    • 제39권1호
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    • pp.86-94
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    • 2024
  • Background/Aims: A catheter is inserted through the nasal cavity during high-resolution esophageal manometry (HRM), which may cause adverse events such as pain or epistaxis. Despite these possible safety considerations, studies on this subject are very limited. We aimed to investigate the usefulness of nasal cavity evaluation before HRM to reduce the risk of adverse events and test failure. Methods: Patients who underwent HRM after consultation with the ear-nose-throat department for nasal evaluation were retrospectively enrolled between December 2021 and May 2022. The included patients had a previous history of sinonasal disease or surgery or had subjective nasal discomfort. All patients answered the Sino-Nasal Outcome Test (SNOT-22) questionnaire, and subjective nasal discomfort was scored using a visual analog scale. Nasal endoscopy and acoustic rhinometry were performed for disease evaluation and volumetric assessment. Results: The analysis included 22 patients with a mean age of 58.9 years. The mean SNOT-22 score was 24.2, and 16 patients (72.7%) complained of subjective nasal obstruction. The HRM catheter was successfully inserted in 20 patients (90.9%), without any significant adverse events. The objective measurement outcomes of acoustic rhinometry and sinus endoscopy did not always correspond to subjective symptoms. Narrowed nasal airways unresponsive to decongestants were observed in two patients with failed catheter insertion. Conclusions: To reduce the risk of adverse events and test failure during HRM, a site-specific questionnaire to evaluate nasal obstruction might be helpful. When nasal obstruction is suspected, objective nasal cavity evaluation could be recommended for the safe and successful performance of HRM.

Auricular conchal cartilage for treatment of empty nose syndrome

  • Min Jai Cho;Hahn Jin Jung
    • Journal of Medicine and Life Science
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    • 제20권4호
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    • pp.183-187
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    • 2023
  • Empty nose syndrome is an uncommon complication of turbinoplasty and other nasal operations. It presents with various manifestations, with the most common symptom being paradoxical nasal obstruction. Here, we report the case of a 67-year-old male patient diagnosed with empty nose syndrome 20 years after turbinoplasty. Autologous auricular conchal cartilage was harvested and implanted into the lateral wall of the inferior turbinate to reduce nasal volume. The patient experienced significant relief from subjective nasal obstruction symptoms immediately after surgery. Over a 23-month follow-up period, no side effects or symptom recurrence was reported.

전신마취 후 칼드웰럭씨 수술을 통한 extubation 시행시 발생한 급성 폐부종: 증례보고 (ACUTE PULMONARY EDEMA CAUSED BY IMPAIRED SWITCHING FROM NASAL TO ORAL BREATHING DURING THE CALDWELL-LUC OPERATION RESULTING FROM ANESTHESIA: A CASE REPORT)

  • 오민석;김수관
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권2호
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    • pp.157-160
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    • 2006
  • Nasotracheal intubation is performed routinely in maxillofacial surgery to optimize visualization of the surgical field. The CaldwellLuc operation is an approach to the maxillary sinus through the labiogingival sulcus and canine fossa. The operation is used to treat chronic maxillary sinusitis, and involves curettage of the mucosa of the maxillary sinus and the creation of an inferior meatal antrostomy. After the operation, a nasal Foley catheter is inserted into the inferior nasal meatus for the discharge of blood and tissue fluid. Then, the nostril is packed with vaseline gauze. Before the patients awaken, they experience impaired switching from nasal to oral breathing. Pulmonary edema can result from excessive negative intrathoracic pressure caused by acute airway obstruction in patients breathing spontaneously. During anesthesia and sedation, airway obstruction can occur at the levels of the pharynx and larynx. Even in patients who are awake, alteration in the ability to change the breathing route from nasal to oral may affect breathing in the presence of an airway obstruction, causing this catastrophic event. We experienced a case in which acute pulmonary edema resulted from acute airway obstruction triggered by the patient's inability to switch the breathing route from nasal to oral during emergence from anesthesia.