Correlation between acoustic rhinometry, computed rhinomanometry and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency

Sakai, Raquel Harumi Uejima Satto; Marson, Fernando Augusto Lima; Sakuma, Emerson Taro Inoue; Ribeiro, José Dirceu; Sakano, Eulália

doi:10.1016/j.bjorl.2016.10.015

Raquel Harumi Uejima Satto Sakai

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil

Fernando Augusto Lima Marson

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Genética Médica, Campinas, SP, Brazil

Emerson Taro Inoue Sakuma

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas, SP, Brazil

José Dirceu Ribeiro ^** Corresponding author. E-mail:jdirceuribeiro@gmail.com (J.D. Ribeiro).

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil

Eulália Sakano

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Oftalmologia e Otorrinolaringologia, Campinas, SP, Brazil

* Corresponding author. E-mail:jdirceuribeiro@gmail.com (J.D. Ribeiro).

Conflicts of interest

The authors declare no conflicts of interest.

Figures (3)
Tables (4)

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Figure 1
Sagittal and axial planes used for protocol for the reformatted coronal planes (Widths 1-5). Widths 1 and 2 - head of the inferior turbinate; Widths 3 and 4 - head of the middle turbinate; Width 5 - maxillary bone.

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Figure 2
Positive correlation between the data obtained in the acoustic rhinometry, computed rhinomanometry and cone-beam computed tomography. A, Correlation between flow of computed rhinomanometry and nasal volume of 0-5 cm of acoustic rhinometry. (Rho = 0.421; 95% CI = 0.072-0.679). B, Correlation between flow of computed rhinomanometry with the nasal volume of 2-5 of acoustic rhinometry (Rho = 0.393; 95% CI = 0.038-0.660). C, Correlation between flow of computed rhinomanometry and the minimum cross-sectional area 1 of acoustic rhinometry (Rho = 0.375; 95% IC = 0.017-0.648). D, Correlation between Width 4 of cone-beam computed tomography and flow of computed rhinomanometry (Rho = 0.380; 95% CI = 0.023-0.651). E, Correlation between Width 5 of cone-beam computed tomography and flow of computed rhinomanometry. (Rho = 0.371; 95% CI = 0.013-0.645). F, Correlation between Width 3 of cone-beam computed tomography and minimum cross-sectional area 1 of the acoustic rhinometry (Rho = 0.380; 95% CI = 0.022-0.651). Statistical analysis performed by Spearman's correlation test.

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Figure 3
Negative correlation between the data obtained in the acoustic rhinometry, computed rhinomanometry and cone-beam computed tomography. A, Correlation between average inspiratory resistance of computed rhinomanometry and nasal volume of 0-5 cm of acoustic rhinometry (Rho = −0.382; −0.653 to −0.026). B, correlation between average expiratory resistance of computed rhinomanometry and minimum cross-sectional area 1 of acoustic rhinometry (Rho = −0.362; 95% CI = −0.639 to −0.001). C, Correlation between Width 4 of cone-beam computed tomography and average inspiratory resistance of computed rhinomanometry (Rho = −0.385; 95% CI = −0.654 to −0.029). Statistical analysis was performed by Spearman's correlation test.

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Table 1
Descriptive analysis of acoustic rhinometry, computed rhinomanometry and cone-beam computed tomography of maxilla and nasal cavity in mouth breathers with transverse maxillary deficiency and comparison between the values of acoustic rhinometry and computed rhinomanometry tests, with or without the use of nasal vasoconstrictor.

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Table 2
Correlation between data of acoustic rhinometry and computed rhinomanometry in mouth breathers with transverse maxillary deficiency, as well as between width 5 and width 1 to 4 of cone- beam computed tomography of maxilla and nasal cavity.

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Table 3
Correlation between data of cone-beam computed tomography and computed rhinomanometry in mouth breathers with transverse maxillary deficiency.

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Table 4
Correlation between data of cone-beam computed tomography and acoustic rhinometry in mouth breathers with transverse maxillary deficiency.

Examination	Marker	Vasoconstritor	Mean	Standard deviation	Median	Minimum	Maximum
Acoustic rhinometry	Nasal cavity volume 0-5 cm (cm³)	With	18.77	9.10	14.18	9.29	39.44
	Nasal cavity volume 0-5 cm (cm³)	Without	12.02	4.81	11.16	5.75	31.18
	Nasal cavity volume 2-5 cm (cm³)	With	15.50	8.31	11.22	6.4	34.6
	Nasal cavity volume 2-5 cm (cm³)	Without	9.16	4.37	8.46	3.47	26.95
	MCA 1 (cm²)	With	2.71	1.84	2.13	0.98	7.38
	MCA 1 (cm²)	Without	1.49	0.97	1.24	0.74	6.06
	MCA 2 (cm²)	With	5.50	3.03	4.65	1.84	12.28
	MCA 2 (cm²)	Without	3.38	2.05	2.69	0.72	10.77
Computed rhinomanometry	Flow (cm³/s)	With	549.27	207.54	539	139	966
	Flow (cm³/s)	Without	329.43	159.77	304	48	703
	Average inspiratory resistance (Pa/cm³/s)	With	1.62	1.42	1.19	0.62	6.45
	Average inspiratory resistance (Pa/cm³/s)	Without	3.05	2.96	2.35	0.95	17.18
	Average expiratory resistance (Pa/cm³/s)	With	1.52	1.15	1.07	0.70	5.17
	Average expiratory resistance (Pa/cm³/s)	Without	3.81	3.82	2.70	0.98	18.02
Cone-beam computed tomography	Width 1		2.10	0.22	2.10	1.61	2.58
	Width 2		2.63	0.59	2.73	1.21	3.87
	Width 3		1.95	0.25	1.95	1.56	2.46
	Width 4		4.38	0.59	4.18	3.47	5.94
	Width 5		6	0.55	6.08	3.78	6.69

Computed rhinomanometry	Acoustic rhinometry
	Nasal cavity vol. 0-5 cm		Nasal cavity vol. 2-5 cm		Minimum cross-sectional area 1		Minimum cross-sectional area 2
	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor
Flow (p-value)	0.2926	0.0204	0.3648	0.0318	0.9265	0.0413	0.6927	0.0708
Rho coefficient	0.199	0.421	0.172	0.393	-0.0176	0.375	0.0752	0.335
95% CI	-0.174 to 0.522	0.072 to 0.679	-0.201 to 0.501	0.038 to 0.660	-0.375 to 0.345	0.017 to 0.648	-0.293 to 0.424	-0.029 to 0.620
AIR (p-value)	0.3866	0.0370	0.4724	0.0550	0.7649	0.0988	0.8253	0.1593
Rho coefficient	-0.164	-0.382	-0.136	-0.354	0.0570	-0.307	-0.0421	-0.263
95% CI	-0.495 to 0.209	-0.653 to 0.026	-0.473 to 0.235	-0.633 to 0.007	-0.310 to 0.409	-0.601 to 0.0598	-0.396 to 0.323	-0.570 to 0.107
AER (p-value)	0.1794	0.0983	0.2556	0.1607	0.5488	0.0496	0.6733	0.3347
Rho coefficient	-0.252	-0.307	-0.214	-0.263	-0.114	-0.362	-0.0803	-0.182
95% IC	-0.561 to 0.119	-0.601 to 0.059	-0.533 to 0.158	-0.569 to 0.108	-0.456 to 0.257	-0.639 to -0.001	-0.428 to 0.288	-0.509 to 0.190
Tomography	Width 1		Width 2		Width 3		Width 4
Width 5 (p-value)	0.020		0.0242		0.0950		0.0181
Rho coefficient	0.542		0.411		0.310		0.429
95% CI	0.226-0.755		0.059-0.672		-0.056-0.603		0.081-0.683

Cone-beam computed tomography	Computed rhinomanometry
	Flow		AIR		AER
	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor
Width 1 (p-value)	0.3312	0.7293	0.2159	0.8821	0.3874	0.6032
Rho coefficient	-0.184	0.0659	0.233	-0.0283	0.164	0.0989
95% CI	-0.510 to 0.189	-0.302 to 0.416	-0.139 to 0.547	-0.385 to 0.335	-0.209 to 0.495	-0.271 to 0.443
Width 2 (p-value)	0.2774	0.1790	0.2658	0.3449	0.0752	0.1077
Rho coefficient	0.205	0.252	-0.210	-0.179	-0.330	-0.300
95% CI	-0.168 to 0.526	-0.119 to 0.561	-0.530 to 0.163	-0.506 to 0.194	-0.617 to 0.035	-0.596 to 0.068
Widht 3 (p-value)	0.4810	0.2560	0.4847	0.6859	0.2793	0.9015
Rho coefficient	-0.134	0.2014	0.133	-0.0770	0.204	-0.0236
95% CI	-0.471 to 0.235	-0.158 to 0.533	-0.239 to 0.470	-0.425 to 0.291	-0.169 to 0.526	-0.381 to 0.340
Width 4 (p-value)	0.4982	0.0384	0.6126	0.0357	0.2311	0.0816
Rho coefficient	0.129	0.380	-0.0963	-0.385	-0.225	-0.323
95% CI	-0.243 to 0.467	0.023 to 0.651	-0.441 to 0.273	-0.654 to -0.029	-0.542 to 0.147	-0.612 to 0.042
Width 5 (p-value)	0.4691	0.0433	0.570	0.0764	0.4007	0.1424
Rho coefficient	0.137	0.371	-0.103	-0.328	-0.159	-0.241
95% CI	-0.235 to 0.474	0.013 to 0.645	-0.447 to 0.237	-0.616 to 0.036	-0.491 to 0.213	-0.578 to 0.095

Cone-beam computed tomography	Acoustic rhinometry
	Nasal cavity vol. 0-5 cm		Nasal cavity vol. 2-5 cm		Minimum cross-sectional area 1		Minimum cross-sectional area 2
	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor	With vasoconstrictor	Without vasoconstrictor
Width 1 (p-value)	0.9534	0.2050	0.8830	0.2442	0.4223	0.2932	0.5288	0.9529
Rho coefficient	-0.011	0.238	0.028	0.219	0.152	0.198	0.120	0.0113
95% CI	-0.370 to 0.351	-0.134 to 0.551	-0.336 to 0.384	-0.153 to 0.537	-0.220 to 0.486	-0.174 to 0.521	-0.251 to 0.460	-0.350 to 0.370
Width 2 (p-value)	0.3775	0.2742	0.4242	0.3281	0.3221	0.0385	0.4150	0.5556
Rho coefficient	0.167	0.206	0.152	0.185	0.187	0.380	0.154	0.112
95% CI	-0.206 to 0.497	-0.166 to 0.527	-0.221 to 0.485	-0.188 to 0.511	-0.186 to 0.513	0.022 to 0.651	-0.218 to 0.488	-0.259 to 0.454
Width 3 (p-value)	0.3387	0.6353	0.3832	0.7242	0.4977	0.5196	0.6780	0.9246
Rho coefficient	-0.181	0.090	-0.165	0.067	-0.129	0.122	-0.0791	0.0180
95% CI	-0.508 to 0.192	-0.279 to 0.436	-0.496 to 0.207	-0.300 to 0.417	-0.467 to 0.243	-0.249 to 0.462	-0.427 to 0.289	-0.344 to 0.376
Width 4 (p-value)	0.3622	0.0408 ^a a The same Rho coefficient and 95% CI were observed.	0.444	0.0408 ^a a The same Rho coefficient and 95% CI were observed.	0.0190	0.0245	0.2770	0.5727
Rho coefficient	0.172	0.376	0.145	0.376	0.426	0.410	0.227	0.107
95% CI	-0.200 to 0.502	0.018 to 0.648	-0.227 to 0.480	0.018 to 0.648	0.077 to 0.682	0.058 to 0.671	-0.145 to 0.543	-0.263 to 0.450
Width 5 (p-value)	0.9311	0.0955	0.9916	0.1152	0.9441	0.1543	0.9246	0.4411
Rho coefficient	-0.017	0.310	0.002	0.294	0.0134	0.267	0.0180	0.146
95% CI	-0.375 to 0.346	-0.057 to 0.603	-0.359 to 0.362	-0.075 to 0.591	-0.349 to 0.372	-0.104 to 0.572	-0.344 to 0.376	-0.226 to 0.481

[1] * Corresponding author. E-mail:jdirceuribeiro@gmail.com (J.D. Ribeiro).

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Abstract

Introduction

Objective

Methods

Results

Conclusion