Mohan S, et al. - Researchers reviewed advances in diagnosis and treatment of nasal airway obstruction (NAO) from the last 5 years. NAO is a clinical diagnosis and has a considerable influence on quality of life (QOL). A focused history and physical examination were found to be the initial components for an adequate diagnosis, which required a patient QOL measure such as the Nasal Obstruction Symptom Evaluation (NOSE) scale as well. Objective measures should be adjunctive.

Methods

• Using terms nasal obstruction and nasal blockage and their permutations, researchers searched PubMed, Embase, CINAHL, the Cochrane Library, LILACS, Web of Science, and Guideline.gov from July 26, 2012, through October 23, 2017.
• This analysis included studies which assessed NAO using a subjective and an objective technique, and in the case of intervention-based studies, the Nasal Obstruction Symptom Evaluation (NOSE) scale and an objective technique.
• The following were included in exclusion criteria: animal studies; patients younger than 14 years; nasal foreign bodies; nasal masses including polyps; choanal atresia; sinus disease; obstructive sleep apnea or sleep-disordered breathing; allergic rhinitis; and studies not specific to nasal obstruction.

Results

• A total of 942 articles were initially identified.
• Two investigators performed independent screening, after which 46 unique articles remained, including 2 randomized clinical trials, 3 systematic reviews, 3 meta-analyses, and 39 nonrandomized cohort studies (including a combined systematic review and meta-analysis).
• The review (including meta-analyses) consisted an aggregate of approximately 32,000 patients.
• Findings revealed that with regard to disease-specific validation and correlation with symptoms, the NOSE scale was outstanding among the subjective measures available for NAO.
• No currently available objective measure can be considered a criterion standard.
• Although necessity of structural measures of flow, pressure, and volume was shown but these were insufficient to assess NAO.