title: Usefulness of rhinomanometry in the identification and treatment of patients with obstructive sleep apnoea: an algorithm for predicting the relationship between nasal resistance and continuous positive airway pressure. a retrospective study.
abstract: OBJECTIVE
  We tried to assess the relationship between nasal resistance measured by rhinomanometry and the pressure used in CPAP.
  
  
  METHODS
  Retrospective medical case series review, January 2004 to December 2014.
  
  
  METHODS
  Tertiary care academic medical centre.
  
  
  METHODS
  Thirty-eight patients (m = 56.55 years; male = 90.5%) with CPAP settings ≤8 and 39 patients (m = 57.49 years; male = 74.9%) with pressure settings ≥12.
  
  
  METHODS
  Study variables were BMI, neck circumference, Epworth Sleepiness Scale score, nasopharyngeal examination and computerised anterior active rhinomanometry, sitting and supine, in basal conditions and after intranasal administration of oxymetazoline (0.05%). Nocturnal polysomnography was performed to calculate the apnoea-hypopnoea index without and with CPAP to analyse the effectiveness of the treatment.
  
  
  RESULTS
  BMI and resistance in supine position after vasoconstriction at 150 Pa were useful variables to predict the pressure setting that should be used. We obtained an equation to calculate the probability that a patient requires a pressure >12 cm H2O as a function of their BMI and total nasal airflow at 150 pascal in supine position after vasoconstriction.
  
  
  CONCLUSIONS
  Rhinomanometry is useful to predict the impact of structural nasal modifications on the positive pressure to support decision-making in relation to surgery.
authors.affiliation: Otorhinolaryngology Service, University Hospital of Araba, Vitoria, Spain.|School of Medicine, University of the Basque Country, Bilbao, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Hueto
authors.affiliation: School of Medicine, University of the Basque Country, Bilbao, Spain.|Otorhinolaryngology Service, University Hospital of Basurto, Bilbao, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Santaolalla
authors.affiliation: School of Medicine, University of the Basque Country, Bilbao, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sanchez-Del-Rey
authors.affiliation: School of Medicine, University of the Basque Country, Bilbao, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Martinez-Ibargüen
mesh_terms: D000403:Airway Resistance / Q000502:physiology*; D000465:Algorithms; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D017286:Polysomnography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D025363:Rhinomanometry; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy*