Comparison of anatomic, physiological, and subjective measures of the nasal airway

Background: Studies comparing different categories of nasal measures have reported inconsistent results. We sought to compare validated measures of the nasal airway: anatomic (acoustic rhinometry), physiological (nasal peak inspiratory flow), and subjective experience (Nasal Obstruction Symptom Evaluation Scale and a visual analog scale [VAS]). Methods: This prospective cross-sectional study of 290 nonrhinologic patients included upright and supine rhinometry (minimum cross sectional area [MCA] and volume) and flow (mean and maximum) measurements, as well as subjective measures. Associations between measures were evaluated with Spearman correlations and multivariate linear regression, adjusting for age, sex, race, body mass index, and smoking history. Results: Correlations between objective (rhinometry and flow) and subjective categories of nasal measures ranged from -0.16 to 0.03 (mean correlation, -0.07 ± 0.05), with 0 significant correlations of 16 tested. Correlations between anatomic (rhinometry) and physiological (flow) categories ranged from 0.04 to 0.15 (mean correlation, 0.10 ± 0.03), with 0 significant correlations of 16 tested. In contrast, within each category (rhinometry, flow, and subjective), all correlations were significant (13 correlations, all p < 0.001) and ranged from 0.62 to 0.99. Of 16 adjusted associations between objective and subjective measures, 14 were not significant (p > 0.05); only upright and supine MCAs were significantly associated with the VAS (both, p < 0.05). Conclusion: Validated anatomic, physiological, and subjective nasal measures may assess different aspects of the nasal airway and provide complementary information. Future studies should be directed at developing a composite measure including components from all three categories of nasal measurement.