客観的評価に基づいた鼻閉の診断と治療

抄録

Rhinomanometry and acoustic rhinometry are useful tools for the objective assessment of nasal patency. Nasal patency during breathing is required as one of the measures of respiratory function because difficulty in nasal breathing is affected by any decrease in respiratory function. The nasal mucosa automatically changes depending on many different factors. The phenomenon of the nasal cycle is important in the understanding of the pathophysiology of nasal disease. Pollen allergy patients showed a dynamic change in their nasal cycle in the pollen season. Nasal cycle changes have also been shown during sleep and the duration of cycle was longer than in the daytime. Furthermore, the nasal cycle may correlate with the sleep cycle.
The challenge test is important to evaluate nasal patency in patients with nasal disease. Malm introduced guidelines regarding a challenge test for the antigens, histamine and methacoline. These tests showed the reactivity of the nasal mucosa. Nasal patency also changes with exercise. The nasal mucosa was found to be particularly more swollen in patients with allergic rhinitis, so called exercise-induced nasal obstruction. Silvers also defined these changes as exercise-induced allergies. Exercise-induced nasal obstruction was not observed after management with steroids and anti-histamines. The symptom of nasal obstruction will decrease when medication is administered for allergic rhinitis. In conclusion, objective assessment is important to decide the proper plan to treat nasal disease.