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Judit Papp, MD; Richard Leiacker, MSc; Tilman Keck, MD; Ajnacska Rozsasi, MD; Thomas Kappe, MD

Arch Otolaryngol Head Neck Surg. 2008;134(9):931-935.

Objectives  To compare nasal-air conditioning in patients with chronic rhinosinusitis with nasal polyposis with healthy control subjects without nasal pathologic conditions, to investigate nasal-air conditioning after endoscopic sinus surgery with and without septoplasty and turbinoplasty 4 to 6 weeks after surgery, to examine the parameters of nasal patency and nasal geometry that possibly influence nasal-air conditioning before and after endonasal surgery, and to determine their relationship to nasal-air conditioning parameters.

Design  Prospective cohort study.

Setting  Tertiary referral center.

Participants  Twenty-five patients (median age, 51 years; age range, 20-74 years) having a diagnosis of chronic rhinosinusitis with nasal polyposis refractory to medical treatment and 22 healthy control subjects (median age, 25 years; age range, 18-52 years).

Intervention  Patients underwent endoscopic sinus surgery with or without septoplasty and turbinoplasty during 6 months and were followed up 4 to 6 weeks after surgery.

Main Outcome Measures  Nasal-air conditioning was measured and acoustic rhinometry and active anterior rhinomanometry were performed before and after nasal surgery.

Results  Nasal airflow and nasal volume were significantly higher postoperatively than preoperatively. The preoperative heat increase and water gradient were lower in the patients compared with the controls. The postoperative heat increase was significantly higher than the preoperative values. The water gradient did not change after endonasal surgery. Nasal patency and volume were positively correlated with nasal heating, whereas nasal humidification showed a significant negative correlation with nasal volume.

Conclusions  Patients with chronic rhinosinusitis with nasal polyposis seem to benefit from endoscopic sinus surgery with or without septoplasty and turbinoplasty because nasal heating is improved postoperatively. Four to 6 weeks after endonasal surgery, nasal humidification is neither improved nor worsened compared with preoperative values.

Author Affiliations: Department of Pediatric Oncology, University Children's Hospital (Dr Papp), and Departments of Otorhinolaryngology–Head and Neck Surgery (Mr Leiacker and Drs Keck and Rozsasi) and Orthopaedic Surgery (Dr Kappe), University of Ulm, Ulm, Germany.