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KMID : 0378019630060120091
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New Medical Journal
1963 Volume.6 No. 12 p.91 ~ p.118
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Clinical Study of the Relationship between the Patency of Ostium and Air Pressures in the Nose and Maxillary Sinus
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Abstract
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The patency of the ostium is one of the important barometer for the treatment of paranasal sinusitis.
The author emphasizes that the air pressures irr the nose and maxillary sinus clearly indicating the state of patency of ostium, sinuses under normal and various abnormal conditions of the nose. The author could draw the following conclusions about the relationship between the patency of ostium and the pressure of nose and maxillary sinus.
1. The pressures of nose and maxillary sinus do indicate the state of patency of the ostium, so that it should be used as one of the routine procedures in clinical diagnosis.
2. Under conditions in which the ostium is normal.
a) The pressure of the sinus is always the same as the nasal cavity without any time lag.
b) On inspiration, antral and nasal pressure (A.P and N.P); average -4.075 mm. H2O. After shrinkage of the nasal mucosa (AF. SH), it is35,705 mm. H2O. On the expiration, A.P. and N.P.; -1-6.000 mm. H2O AF. SH.; +4.750 mm. H2O. The average pressure change of sinus and nasal cavity during normal respiration is 10.075 mm. H2O.
c) On the strong inspiration (sniffing).
A.P.: -38.125 mm. H2O.
N.P.: -50.000 mm. H2O.
AF. SH.: A.P.: -26.500 mm. H2O, N.P.: -29.125 mm. H2O.
When one side of the nose is closed,
A.P. of the closed side: -12.500 mm. H2O.
A.P. and N.P. of the other side: -150.875 mm. H2O.
N.P. of the other side: -125.875 mm. H2O.
AF. SH. A.P. of closed side: -8.625 mm. H2O.
A.P. of the other side: + 125.750 mm. H2O.
N.P. of the other side: -1-125.875 mm. H2O.
d) On strong expiration (blowing).
A.P. and N.P.: -}-93.000 mm. H2O.
AF. SH.: +53.625 mm. H2O.
When one side of the nose is closed.
Closed side: A.P. -{-274.250 mm. H2O.
AF. SH.: x-231.250 mm. H2O.
The other side, A.P.: -{-205.625 mm. H2O.
N.P.: -1-205.500 mm. H2O.
AF. SH. N.P. and A.P.: -1-171.375 mm. H20-
3. Under conditions in which the ostium is abnormal.
a) The A.P. needs some time lag to be the same as the N.P.
b) When the ostium is significantly narrowed, the A.P. is not always the same as N.P.
c) Under conditions in which ostium is moderately narrowed, the peak pressures produced by strong respiration (sniffing or blowing) tend to be maintained until offset by strong respiration of the opposite type (blowing or sniffing).
d) Under conditions in which the ostium is markedly narrowed, the stronger respirations than sniffing or blowing, ramely sneezing or the removal of tube from the sinus may be needed to offset peak pressures obtained by initial strong respirations.
e) The narrower the anterior naris, the higher the N.P. and A.P.
f) The wider the anterior nasal naris, the lower the A.P. and N.P.
g) In complete obstruction of the ostium, no A.P. is obtained.
h) When the ostium is obstructed with tissure, vasoconstrictors, if effective, markedly alter AF. SH. pressures. In retension cyst of the sinus, vasoconstrictors are not overly effective in changing pressures.
i) The narrower the posterior nasal naris, or nasopharynx, the lower the N.P. and A.P.
j) In the complete obstruction of the posterior naris and nasopharynx, no N.P. or A.P. is obtainable.
k) The author suggests that for convenience of clinical discription. obstruction of the ostium be
classified as first, second or third degree, depending upon pressure change studies of the sinus.
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