Predictors of Nasal Obstruction: Quantification and Assessment Using Multiple Grading Scales.
Objective. To evaluate the association between nasal obstruction and (1) demographic factors, (2) medical history, (3) physical tests, and (4) nasal exam findings. Study Design.


METHODS
Methods. Chart review at a tertiary medical center. Results. Two hundred-forty consecutive patients (52.1 ± 17.5 years old, with a Nasal Obstruction Symptom Evaluation (NOSE) score of 32.0 ± 24.1) were included. Demographic factors and inferior turbinate sizes were not associated with NOSE score or Nasal Obstruction Visual Analog Scale (NO-VAS). A significant association was found between higher NOSE score on univariate analysis and positive history of nasal trauma (p = 0.0136), allergic rhinitis (p < 0.0001), use of nasal steroids (p = 0.0108), higher grade of external nasal deformity (p = 0.0149), higher internal nasal septal deviation grade (p = 0.0024), and narrow internal nasal valve angle (p < 0.0001). Multivariate analysis identified the following as independent predictors of high NOSE score: NO-VAS: ≥50 (Odds Ratio (OR) = 17.6 (95% CI 5.83-61.6), p < 0.0001), external nasal deformity: grades 2-4 (OR = 4.63 (95% CI 1.14-19.9), p = 0.0339), and allergic rhinitis: yes (OR = 5.5 (95% CI 1.77-18.7), p = 0.0041). Conclusion. Allergic rhinitis, NO-VAS score ≥ 50, and external nasal deformity (grades 2-4) were statistically significant independent predictors of high NOSE scores on multivariate analysis. Inferior turbinate size was not associated with NOSE scores or NO-VAS.
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI 96859, USA; Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, CA 94063, USA.
Macario
M
Camacho
Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Stanford Hospitals and Clinics, Stanford, CA 94304, USA; Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Soroush
S
Zaghi
Department of Otorhinolaryngology, Sleep Medicine Centre, Hospital CUF, 4100-180 Porto, Portugal; Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, 4200-450 Porto, Portugal.
Victor
V
Certal
Department of Otorhinolaryngology, Hospital Bernardino Rivadavia, C1425ASQ Buenos Aires, Argentina.
Jose
J
Abdullatif
Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Stanford Hospitals and Clinics, Stanford, CA 94304, USA; Department of Otolaryngology-Head and Neck Surgery, Dr. L. H. Hiranandani Hospital Mumbai, Maharashtra 400076, India.
Rahul
R
Modi
Otolaryngology-Head and Neck Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA.
Shankar
S
Sridhara
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Anthony M
AM
Tolisano
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Edward T
ET
Chang
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Benjamin B
BB
Cable
Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Stanford Hospitals and Clinics, Stanford, CA 94304, USA.
Robson
R
Capasso