Skip to main content
SpringerLink
Log in

Peak nasal inspiratory flow: a useful and handy tool for the diagnosis of nasal obstruction in the elderly

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The global population is aging, with the over-65 age group expected to double in the USA by 2030. Three subcategories of elderly people have been identified: “young old” (from 65 to 74 years), “older old” (from 75 to 84) and “oldest old” (85 or more). Rhinosinusitis is a common disease that affects more than 31 million people in the USA every year. Nasal obstruction is one of the most common symptoms in patients affected by rhinosinusitis. An accurate nasal obstruction evaluation in the elderly is becoming of increasing interest for medical doctors, especially for geriatricians. Peak nasal inspiratory flow (PNIF) is a cheap and easy method for assessing nasal patency. The purpose of the study was to compare young old normal PNIF values with older old normal PNIF values. Charts relating PNIF normal values in the elderly with various explanatory variables have been provided. PNIF measurements were performed in 113 volunteers aged 65–84 years. One hundred and five of them fulfilled the study criteria and were self-reported healthy elderly. None of them complained of nasal symptoms. Data were statistically analyzed and figures and tables were produced relating PNIF to height, sex and age. PNIF values decreased with age (p = 0.0053) and were significantly lower in the “older old” sub-cohort than in the “young old” group (p = 0.007). Nasal obstruction in the elderly is a common problem and appropriate diagnosis and treatment are important for improving their quality of life. The measurement of PNIF could be useful in evaluating elderly patients who complain of nasal obstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, Cervin A, Douglas R, Gevaert P, Georgalas C, Goossens H, Harvey R, Hellings P, Hopkins C, Jones N, Joos G, Kalogjera L, Kern B, Kowalski M, Price D, Riechelmann H, Schlosser R, Senior B, Thomas M, Toskala E, Voegels R, de Wang Y, Wormald PJ (2012) European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl 23:1–298

    Google Scholar 

  2. Ottaviano G, Marioni G, Staffieri C, Giacomelli L, Marchese-Ragona R, Bertolin A, Staffieri A (2011) Effects of sulfurous, salty, bromic, iodic thermal water nasal irrigations in nonallergic chronic rhinosinusitis: a prospective, randomized, double-blind, clinical, and cytological study. Am J Otolaryngol 32:235–239

    Article  PubMed  Google Scholar 

  3. Nyenhuis SM, Mathur SK (2013) Rhinitis in older adults. Curr Allergy Asthma Rep 13:171–177

    Article  PubMed Central  PubMed  Google Scholar 

  4. Aging and old age as risk factors for multiple primary tumors. http://grants.nih.gov/grants/guide/pa-files/PA-99-030.html

  5. Holmström M, Scadding GK, Lund VJ, Darby YC (1990) Assessment of nasal obstruction. A comparison between rhinomanometry and nasal inspiratory peak flow. Rhinology 28:191–196

    PubMed  Google Scholar 

  6. Prescott CAJ, Prescott KE (1995) Peak nasal inspiratory flow measurement: an investigation in children. Int J Pediatr Otorhinolaryngol 32:137–141

    Article  CAS  PubMed  Google Scholar 

  7. Van Spronsen E, Ebbens FA, Fokkens WJ (2012) Normal peak nasal inspiratory flow rate values in healthy children aged 6 to 11 years in the Netherlands. Rhinology 50:22–25

    PubMed  Google Scholar 

  8. Ottaviano G, Scadding GK, Coles S, Lund VJ (2006) Peak nasal inspiratory flow. Normal range in adult population. Rhinology 44:32–35

    PubMed  Google Scholar 

  9. Ottaviano G, Lund VJ, Coles S, Staffieri A, Scadding GK (2008) Does peak nasal inspiratory flow relate to peak expiratory flow? Rhinology 46:200–203

    PubMed  Google Scholar 

  10. Papachristou A, Bourli E, Aivazi D, Futzila E, Papastavrou Th, Kostandinidis Th, Maratou E, Ilonidis G, Aivazis V (2008) Normal peak nasal inspiratory flow rate values in Greek children and adolescents. Hippokratia 12:94–97

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Klossek JM, Lebreton JP, Delagranda A, Dufour X (2009) PNIF measurement in a healty French population. A prospective study about 234 patients. Rhinology 47:389–392

    PubMed  Google Scholar 

  12. Bouzgarou MD, Saad HB, Chouchane A, Cheikh IB, Zbidi A, Dessanges JF, Tabka Z (2011) North African reference equation for peak nasal inspiratory flow. J Laryngol Otol 125:595–602

    Article  PubMed  Google Scholar 

  13. da Cunha Ibiapina C, de Andrade CR, Moreira Camargos PA, Goncalves Alvim C, Augusto Cruz A (2011) References values for peak nasal inspiratory flow in children and adolescent in Brazil. Rhinology 49:304–308

    PubMed  Google Scholar 

  14. Ottaviano G, Scadding GK, Scarpa B, Accordi D, Staffieri A, Lund VJ (2012) Unilateral peak nasal inspiratory flow, normal values in adult population. Rhinology 50:386–392

    PubMed  Google Scholar 

  15. Ottaviano G, Lund VJ, Nardello E, Scarpa B, Frasson G, Staffieri A, Scadding GK Comparison between unilateral PNIF and rhinomanometry in healthy and obstructed noses. Rhinology (in press)

  16. Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP (2009) Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 34:447–454

    Article  CAS  PubMed  Google Scholar 

  17. van Spronsen E, Ebbens FA, Fokkens WJ (2012) Normal peak nasal inspiratory flow rate values in healthy children aged 6 to 11 years in the Netherlands. Rhinology 50:22–25

    PubMed  Google Scholar 

  18. Gwozdz W, Sousa-Poza A. Ageing, health and life satisfaction of the oldest old: an analysis for Germany. http://ftp.iza.org/dp4053.pdf

  19. Neves MC, Neves YC, Mendes CM, Bastos MN, Camelier AA, Queiroz CF, Mendoza BF, Lemos AC, Junior AD (2013) Evaluation of atopy in patients with COPD. J Bras Pneumol 39:296–305

    Article  PubMed Central  PubMed  Google Scholar 

  20. Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, van Wijk RG, Ohta K, Zuberbier T, Schünemann HJ (2010) Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 126:466–476

    Article  PubMed  Google Scholar 

  21. Slavit DH, Lipton RJ, Kern EB, McCaffrey TV (1990) Rhinolift operation in the treatment of the aging nose. Otolaryngol Head Neck Surg 103:462–467

    CAS  PubMed  Google Scholar 

  22. Havas TE. Nasal obstruction in the elderly. http://www.earnosethroat.com.au

  23. Ramey JT, Bailen E, Lockey RF (2006) Rhinitis medicamentosa. J Investig Allergol Clin Immunol 16:148–155

    CAS  PubMed  Google Scholar 

  24. Slavin RG (2009) Treating rhinitis in the older population: special considerations. Allergy Asthma Clin Immunol 5:9

    Article  PubMed Central  PubMed  Google Scholar 

  25. Yepes-Nuñez JJ, Bartra J, Muñoz-Cano R, Sánchez-López J, Serrano C, Mullol J, Alobid I, Sastre J, Picado C, Valero A (2013) Assessment of nasal obstruction: correlation between subjective and objective techniques. Allergol Immunopathol 41:397–401

    Google Scholar 

Download references

Acknowledgments

We are deeply indebted to the language editing by Professor Dennis Marino, Padova.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Otolaryngology Section, Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128, Padua, Italy

    Giancarlo Ottaviano, Ennio Nardello, Ioannis Mylonakis, Giuliana Frasson, Valentina Iacono, Gino Marioni & Alberto Staffieri

  2. Ear Institute, University College London, London, UK

    Valerie J. Lund

  3. Department of Statistical Sciences, University of Padova, Padua, Italy

    Bruno Scarpa

  4. Geriatric Unit, Department of Medicine, University of Padova, Padua, Italy

    Enzo Manzato

Authors
  1. Giancarlo Ottaviano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valerie J. Lund
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ennio Nardello
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bruno Scarpa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ioannis Mylonakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giuliana Frasson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Valentina Iacono
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Enzo Manzato
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Gino Marioni
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alberto Staffieri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giancarlo Ottaviano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ottaviano, G., Lund, V.J., Nardello, E. et al. Peak nasal inspiratory flow: a useful and handy tool for the diagnosis of nasal obstruction in the elderly. Eur Arch Otorhinolaryngol 271, 2427–2431 (2014). https://doi.org/10.1007/s00405-013-2875-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-013-2875-4

Keywords

Search

Navigation