The use of objective measurements of nasal airflow has a long history; however, its clinical application remains, at most, patchy. The main reason for that has been the lack of convincing studies showing a good correlation between the findings of, for example, anterior rhinomanometry and nasal obstruction, as experienced by the patient. Having said that, an equally patchy relationship exists between chronic rhinosinusitis (CRS) symptoms and sinus opacification (Lund-McKay score), however no one would suggest abolishing sinus CT for the diagnosis and assessment of CRS. The key is interpretation; while the results of rhinomanometry may be insufficient to separate patients with obstruction from those with no obstruction; they appear to be useful to monitor the symptoms of individual patients over time. In this prospective study, the authors followed up 53 patients undergoing radiofrequency ablation for inferior turbinate hypertrophy with anterior rhinomanometry as well as VAS at one, three and six months. They found that objective improvement at one month correlated well with subjective improvement; however, this correlation disappeared after three months. It is very likely that other factors were also at play – with allergy and patient expectations being but two of them.
Objective versus subjective – again!
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