{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:34:51Z","timestamp":1773030891201,"version":"3.50.1"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Impairment of nasal breathing is a highly prevalent and bothersome symptom that affects daily functioning and\/or sleep quality. Those surgeons dealing with patients seeking rhinoplasty need to carefully analyze the preoperative nasal breathing capacity and predict the positive or even negative impact of rhino(septo)plasty on nasal breathing. Given the lack of correlation between the subjective feeling of suboptimal nasal breathing and the objective measurements of nasal flow and nasal resistance, a critical and mainly clinical evaluation of all anatomical, mucosal, and sensory mechanisms involved in nasal obstruction is mandatory. Indeed, thermo-, mechano-, and chemosensory receptors on the nasal mucosa, airflow, and respiratory dynamics might all contribute to the overall perception of nasal breathing capacity. In this review, we provide an overview of the factors determining suboptimal nasal breathing including different diagnostic and experimental tests that can be performed to evaluate nasal flow and nasal resistance and current limitations in our understanding of the problem of nasal breathing in an individual patient. An algorithm for the preoperative or diagnostic workup for nasal obstruction is included that might be useful as a guide for clinicians dealing with patients seeking nose surgery.<\/jats:p>","DOI":"10.1055\/s-0043-1777850","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T23:48:50Z","timestamp":1705362530000},"page":"275-286","source":"Crossref","is-referenced-by-count":3,"title":["Nasal Obstruction: Overview of Pathophysiology and Presentation of a Clinically Relevant Preoperative Plan for Rhino(Septo)plasty"],"prefix":"10.1055","volume":"40","author":[{"given":"Simon","family":"Snoeks","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Velasco","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Medicine, Catholic University of Leuven Faculty of Medicine, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karel","family":"Talavera","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Medicine, Catholic University of Leuven Faculty of Medicine, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter W.","family":"Hellings","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium"},{"name":"Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,1,15]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.18176\/jiaci.0232","article-title":"Position paper on nasal obstruction: evaluation and treatment","volume":"28","author":"A Valero","year":"2018","journal-title":"J Investig Allergol Clin Immunol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"e575","DOI":"10.1055\/s-0040-1722162","article-title":"Quality of life in patients with nasal obstruction after septoplasty: a single institution prospective observational study","volume":"25","author":"J D\u0105browska-Bie\u0144","year":"2021","journal-title":"Int Arch Otorhinolaryngol"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.4193\/Rhino11.252","article-title":"Executive summary of European Task Force document on diagnostic tools in rhinology","volume":"50","author":"P W Hellings","year":"2012","journal-title":"Rhinology"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1111\/all.14199","article-title":"Prevalence and impact of nasal hyperreactivity in chronic rhinosinusitis","volume":"75","author":"M Doulaptsi","year":"2020","journal-title":"Allergy"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"100132","DOI":"10.1016\/j.waojou.2020.100132","article-title":"Prevalence and triggers of self-reported nasal hyperreactivity in adults with asthma","volume":"13","author":"J Feijen","year":"2020","journal-title":"World Allergy Organ J"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/j.otc.2018.05.001","article-title":"Anatomy and physiology of nasal obstruction","volume":"51","author":"D W Hsu","year":"2018","journal-title":"Otolaryngol Clin North Am"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/01945998211052919","article-title":"Empty nose syndrome pathophysiology: a systematic review","volume":"167","author":"D Kanjanawasee","year":"2022","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"10","key":"ref8","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1002\/alr.21368","article-title":"The physiological mechanism for sensing nasal airflow: a literature review","volume":"4","author":"J Sozansky","year":"2014","journal-title":"Int Forum Allergy Rhinol"},{"issue":"37","key":"ref9","doi-asserted-by":"crossref","first-page":"9874","DOI":"10.1523\/JNEUROSCI.2221-07.2007","article-title":"Bimodal action of menthol on the transient receptor potential channel TRPA1","volume":"27","author":"Y Karashima","year":"2007","journal-title":"J Neurosci"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1073\/pnas.0808487106","article-title":"TRPA1 acts as a cold sensor in vitro and in vivo","volume":"106","author":"Y Karashima","year":"2009","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"6653","key":"ref11","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1038\/39807","article-title":"The capsaicin receptor: a heat-activated ion channel in the pain pathway","volume":"389","author":"M J Caterina","year":"1997","journal-title":"Nature"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1152\/physrev.00005.2019","article-title":"Mammalian transient receptor potential TRPA1 channels: from structure to disease","volume":"100","author":"K Talavera","year":"2020","journal-title":"Physiol Rev"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.yjmcc.2019.03.003","article-title":"Activation of the cation channel TRPM3 in perivascular nerves induces vasodilation of resistance arteries","volume":"129","author":"L Alonso-Carbajo","year":"2019","journal-title":"J Mol Cell Cardiol"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1111\/all.15259","article-title":"Epithelial and sensory mechanisms of nasal hyperreactivity","volume":"77","author":"E Velasco","year":"2022","journal-title":"Allergy"},{"issue":"9809","key":"ref15","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1016\/S0140-6736(11)60130-X","article-title":"Allergic rhinitis","volume":"378","author":"A N Greiner","year":"2011","journal-title":"Lancet"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1038\/s41572-020-00227-0","article-title":"Allergic rhinitis","volume":"6","author":"J Bousquet","year":"2020","journal-title":"Nat Rev Dis Primers"},{"issue":"01","key":"ref17","first-page":"S1","article-title":"Clinical practice guideline: allergic rhinitis","volume":"152","author":"M D Seidman","year":"2015","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"618","DOI":"10.4193\/Rhin20.376","article-title":"EUFOREA treatment algorithm for allergic rhinitis","volume":"58","author":"P W Hellings","year":"2020","journal-title":"Rhinology"},{"key":"ref19","first-page":"1","article-title":"European position paper on rhinosinusitis and nasal polyps 2020","volume":"58","author":"W J Fokkens","year":"2020","journal-title":"Rhinology"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1038\/s41572-020-00218-1","article-title":"Adult chronic rhinosinusitis","volume":"6","author":"C Bachert","year":"2020","journal-title":"Nat Rev Dis Primers"},{"issue":"01","key":"ref21","first-page":"85","article-title":"The EUFOREA pocket guide for chronic rhinosinusitis","volume":"61","author":"P W Hellings","year":"2023","journal-title":"Rhinology"},{"issue":"11","key":"ref22","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1111\/all.13200","article-title":"Non-allergic rhinitis: position paper of the European Academy of Allergy and Clinical Immunology","volume":"72","author":"P W Hellings","year":"2017","journal-title":"Allergy"},{"issue":"14","key":"ref23","doi-asserted-by":"crossref","first-page":"3183","DOI":"10.3390\/jcm10143183","article-title":"Review of rhinitis: classification, types, pathophysiology","volume":"10","author":"G A Liva","year":"2021","journal-title":"J Clin Med"},{"issue":"09","key":"ref24","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1111\/cea.12780","article-title":"Pathogenesis of rhinitis","volume":"46","author":"A O Eifan","year":"2016","journal-title":"Clin Exp Allergy"},{"issue":"08","key":"ref25","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s11882-016-0638-1","article-title":"Capsaicin for rhinitis","volume":"16","author":"W Fokkens","year":"2016","journal-title":"Curr Allergy Asthma Rep"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.otc.2009.01.004","article-title":"Diagnosis of nasal airway obstruction","volume":"42","author":"R K Chandra","year":"2009","journal-title":"Otolaryngol Clin North Am"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1002\/alr.22965","article-title":"Surgical repair of nasal septal perforations: a systematic review and meta-analysis","volume":"12","author":"J M Fermin","year":"2022","journal-title":"Int Forum Allergy Rhinol"},{"issue":"08","key":"ref28","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1002\/lary.27781","article-title":"Septal fractures predict poor outcomes after closed nasal reduction: retrospective review and survey","volume":"129","author":"M A Arnold","year":"2019","journal-title":"Laryngoscope"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"g6075","DOI":"10.1136\/bmj.g6075","article-title":"Nasal septal haematoma","volume":"349","author":"L N Sanyaolu","year":"2014","journal-title":"BMJ"},{"issue":"06","key":"ref30","first-page":"411","article-title":"Septoplasty versus septoplasty with turbinate reduction for nasal obstruction due to deviated nasal septum: a systematic review and meta-analysis","volume":"60","author":"G Bin Lajdam","year":"2022","journal-title":"Rhinology"},{"issue":"06","key":"ref31","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.ijporl.2011.03.010","article-title":"Nasal septal abscess in children: from diagnosis to management and prevention","volume":"75","author":"N Alshaikh","year":"2011","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"e125","DOI":"10.1097\/SCS.0000000000006854","article-title":"Nasal septal hematoma and abscess in children: an uncommon otorhinolaryngology emergency revisited","volume":"32","author":"I Sayin","year":"2021","journal-title":"J Craniofac Surg"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Y P Chen","year":"2019","journal-title":"Lancet"},{"issue":"11","key":"ref34","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1055\/s-0034-1382027","article-title":"Nasaler Atembeschlagtest bei Zwaardemaker und Glatzel vor \u00fcber 100 Jahren und in Paestum vor 2\u2009300 Jahren [Test using vapourated expired nasal breathing in medicine 100 years ago and in paestum 2\u2009300 years ago]","volume":"93","author":"W Pirsig","year":"2014","journal-title":"Laryngorhinootologie"},{"issue":"02","key":"ref35","first-page":"215","article-title":"Modified Glatzel mirror test reproducibility in the evaluation of nasal patency","volume":"74","author":"S Brescovici","year":"2008","journal-title":"Rev Bras Otorrinolaringol (Engl Ed)"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin19.410","article-title":"European position paper on diagnostic tools in rhinology","volume":"57","author":"J Rimmer","year":"2019","journal-title":"Rhinology"},{"issue":"09","key":"ref37","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.3390\/jpm12091513","article-title":"Correlations between peak nasal inspiratory flow, acoustic rhinometry, 4-phase rhinomanometry and reported nasal symptoms","volume":"12","author":"G Ottaviano","year":"2022","journal-title":"J Pers Med"},{"issue":"06","key":"ref38","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1524-4733.2007.00201.x","article-title":"Development and validation of the Congestion Quantifier seven-item test (CQ7): a screening tool for nasal congestion","volume":"10","author":"D E Stull","year":"2007","journal-title":"Value Health"},{"issue":"07","key":"ref39","first-page":"499","article-title":"Clinical assessment, diagnosis and management of nasal obstruction","volume":"46","author":"A Esmaili","year":"2017","journal-title":"Aust Fam Physician"},{"issue":"05","key":"ref40","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.otc.2018.05.002","article-title":"Diagnostic algorithm for evaluating nasal airway obstruction","volume":"51","author":"J A Villwock","year":"2018","journal-title":"Otolaryngol Clin North Am"},{"issue":"01","key":"ref41","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/s12955-018-1004-x","article-title":"Adaption and validation of the nasal obstruction symptom evaluation scale in German language (D-NOSE)","volume":"16","author":"C Spiekermann","year":"2018","journal-title":"Health Qual Life Outcomes"}],"container-title":["Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1777850.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T11:45:28Z","timestamp":1730807128000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1777850"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,15]]},"references-count":41,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2024,5,17]]},"published-print":{"date-parts":[[2024,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1777850","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0736-6825","1098-8793"],"issn-type":[{"value":"0736-6825","type":"print"},{"value":"1098-8793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,15]]}}}