Predictors of Nasal Obstruction: Quantification and Assessment Using Multiple Grading Scales

Abstract

Objective . To evaluate the association between nasal obstruction and (1) demographic factors, (2) medical history, (3) physical tests, and (4) nasal exam findings. Study Design . Case series. Methods . Chart review at a tertiary medical center. Results . Two hundred-forty consecutive patients ( 52.1 ± 17.5 years old, with a Nasal Obstruction Symptom Evaluation (NOSE) score of 32.0 ± 24.1 ) were included. Demographic factors and inferior turbinate sizes were not associated with NOSE score or Nasal Obstruction Visual Analog Scale (NO-VAS). A significant association was found between higher NOSE score on univariate analysis and positive history of nasal trauma ( p = 0.0136 ), allergic rhinitis ( p < 0.0001 ), use of nasal steroids ( p = 0.0108 ), higher grade of external nasal deformity ( p = 0.0149 ), higher internal nasal septal deviation grade ( p = 0.0024 ), and narrow internal nasal valve angle ( p < 0.0001 ). Multivariate analysis identified the following as independent predictors of high NOSE score: NO-VAS: ≥50 (Odds Ratio (OR) = 17.6 (95% CI 5.83–61.6), p < 0.0001 ), external nasal deformity: grades 2–4 (OR = 4.63 (95% CI 1.14–19.9), p = 0.0339 ), and allergic rhinitis: yes (OR = 5.5 (95% CI 1.77–18.7), p = 0.0041 ). Conclusion . Allergic rhinitis, NO-VAS score ≥ 50, and external nasal deformity (grades 2–4) were statistically significant independent predictors of high NOSE scores on multivariate analysis. Inferior turbinate size was not associated with NOSE scores or NO-VAS.