Rhinomanometry Case Study

hypertrophy alone. However, if a CT scan of the head, facial bones, or sinuses has been obtained for other reasons, it may provide useful information. Axial and particularly coronal images can help assess the amount of bony versus mucosal hypertrophy.
If clinical presentation raises the concern of other obstructive processes such as nasal polyps or masses, CT imaging of the nose and sinuses should be performed.
Rhinomanometry:
Rhinomanometry is a technique for measuring nasal airway resistance. It is limited in that it does not provide a diagnosis or etiology of the obstruction. It provides a measure of nasal resistance at a specific time.
The technique is performed by applying a tight-fitting mask with a central aperture connected to a low-resistance

Typically, the patient begins using the topical agent to treat an underlying disorder causing nasal obstruction. This disorder still needs to be evaluated.
Treatment involves stopping the topical nasal decongestants.
Topical glucocorticoids and possibly oral glucocorticoid agents can help minimize edema and inflammation and can be of significant benefit in obtaining compliance with cessation of decongestants.
Other medications causing increased nasal congestion include certain antihypertensives, antidepressants, antipsychotics, and oral contraceptives. If these are suspected, alternative medications must be tried. The submucosal injection of corticosteroids has also been used to offer relief from nasal obstruction by reducing turbinate edema. This technique can be used in a variety of clinical settings including allergy, vasomotor rhinitis, rhinitis medicamentosa, and postseptorhinoplasty. The results are rapid in onset with little systemic adverse effects.
However, the results are temporary, lasting weeks to months. This technique serves as a temporizing measure, not as a permanent solution. Surgical treatment:
Turbinate Reduction Rhinoplasty
Surgical therapies can be categorized into those

Repositioning the turbinate laterally within the nasal valve area is accomplished by lateral outfracture. See the image below.
Lateral outfracture
This technique does not address either mucosal or bony hypertrophy but rather the spatial relation of the inferior turbinate within the nasal valve.
Mucosal hypertrophy can be addressed by various techniques focusing either on the mucosal surface or intramurally. The mucosa and submucosa can be addressed with surface electrocautery or laser vaporization. Intramural techniques are designed to produce submucosal tissue injury while preserving overlying mucosa. The resultant tissue loss and subsequent scarring lead to a reduction in bulk of the inferior turbinate mucosa and submucosa. This can be accomplished with cautery (monopolar or bipolar), cryotherapy, or radiofrequency ablation. See the image