Correlation Between Nasal Mucosal Temperature Change and Perception of Nasal Patency

Abstract

Introduction – Nasal airway obstruction (NAO) is a common presentation that remains poorly understood. Recent evidence suggests that nasal mucosal temperature change, rather than airflow detection, is the primary determinant of subjective nasal patency. Thus, this study aims to examine the role of nasal mucosal temperature in the perception of nasal patency using computational fluid dynamics (CFD). Methodology – Healthy adult participants were recruited. Participants completed Nasal Obstruction Symptom Evaluation (NOSE) and Visual Analogue Scale (VAS) questionnaires. A temperature probe was used to measure nasal mucosal temperature at the vestibule, inferior and middle turbinates, and nasopharynx bilaterally. Participants underwent a CT scan of the paranasal sinuses, which was used to create 3D computer models of nasal anatomy to perform CFD analysis of airflow and heat transfer during inspiration. Results – Eleven participants (6 females, 54.5%) with a median age of 27 (IQR 24; 48) were recruited. No significant differences were seen in mean nasal mucosal temperature measurements obtained from temperature probe and CFD analysis (p = >0.05 for all locations). A statistically significant positive correlation was seen between higher nasal mucosal temperature and unilateral VAS, strongest at the left nasopharynx (Pearson r = 0.62; p = 0.019). A statistically significant negative correlation was seen between peak heat flux obtained from CFD simulations and unilateral VAS, stronger on the right side (Pearson r = -0.29; p = 0.0079). No statistically significant correlations were seen between wall shear stress, inspiratory nasal airway resistance or minimum cross-sectional area with unilateral VAS. Conclusion – Lower nasal mucosal temperature and higher heat flux within the nasal cavity correlates with a perception of improved nasal patency in healthy individuals. CFD simulations may prove to be a valuable modality in improving the assessment and management of patients with NAO