Objective measures needed for assessing nasal obstruction

(HealthDay)—The Nasal Obstruction Symptom Evaluation (NOSE) scale is an adequate subjective measure for assessing nasal airway obstruction (NAO), but more objective measures are required for diagnosis and treatment of NAO, according to a review published online May 10 in JAMA Facial Plastic Surgery.

Suresh Mohan, M.D., from Harvard Medical School in Boston, and colleagues reviewed advances in diagnosis and treatment of NAO from the last five years. Studies were included that assessed NAO using a subjective and objective technique, as well as the NOSE scale and an objective technique in the case of intervention-based studies.

Data were reviewed from 46 articles, including two randomized clinical trials, three systematic reviews, three meta-analyses, and 39 non-randomized cohort studies, with an aggregate of about 32,000 patients. The researchers found that the NOSE scale was outstanding for the subjective measures available for NAO in terms of disease-specific validation and correlation with symptoms. None of the objective measures that are currently available can be considered a criterion standard. Structural measures of flow, pressure, and volume are required, but are insufficient for evaluating NAO.

"Objective measures should be adjunctive and require further validation for widespread adoption," the authors write. "These results are limited by minimal high-quality evidence among studies and the risk of bias in observational studies."

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