title: Biofeedback training of nasal muscles using internal and external surface electromyography of the nose.
abstract: BACKGROUND
  The purpose of this paper is to describe the outcome of biofeedback training of nasal muscles in cases of nasal valve stenosis and collapse. The present study was performed to investigate the best way of using surface electromyography (sEMG) in biofeedback training of muscles involved in nasal valve function. In the present study, we present the way of biofeedback training of these muscles introducing the intranasal placement of sEMG electrodes and a home exercise program.
  
  
  METHODS
  A nonrandomized pilot study of patients presenting with symptoms of obstructed nasal breathing was conducted. All selected patients (n = 15) demonstrated nasal valve stenosis with a positive Cottle maneuver and clinically evident nasal valve collapse. Follow-up ranged from 9 to 12 months. Treatment included surface and intranasal EMG biofeedback-assisted specific strategies for nasal muscle education and a home exercise program of specific nasal movements.
  
  
  RESULTS
  All patients exhibited variable subjective improvement. In 86.66% (n = 13), the improvement was proved objectively and there was no need for operation. In 13.33% (n = 2), an endonasal operation was recommended.
  
  
  CONCLUSIONS
  Relieve of obstructed nasal breathing after nasal valve stenosis and/or collapse can be achieved with biofeedback training of nasal muscles and a home exercise program as described. It helps a significant cohort of patients with symptoms of obstructed nasal breathing to avoid surgical intervention.
authors.affiliation: Department of Otolaryngology, Assaf Harofeh Medical Center, Tel Aviv University, Tel Aviv, Israel. vaimed@yahoo.com
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Nathan
authors.initials: N
authors.lastname: Shlamkovich
authors.forename: Alex
authors.initials: A
authors.lastname: Kessler
authors.forename: Ephraim
authors.initials: E
authors.lastname: Eviatar
authors.forename: Samuel
authors.initials: S
authors.lastname: Segal
mesh_terms: D000293:Adolescent; D000328:Adult; D001676:Biofeedback, Psychology; D004576:Electromyography; D004724:Endoscopy; D005081:Exercise Therapy; D005152:Facial Muscles / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000503:physiopathology / Q000628:therapy*; D009666:Nose / Q000503:physiopathology*; D010865:Pilot Projects; D025363:Rhinomanometry; D023842:Rhinometry, Acoustic; D016896:Treatment Outcome