{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T10:56:23Z","timestamp":1768215383358,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T00:00:00Z","timestamp":1768089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: To thoroughly compare acoustic rhinometry (AR) with computed tomography (CT) cross-sectional areas that are approximately perpendicular to the direction of the nasal airflow (CT-CSA). Methods: We retrospectively examined subjects scheduled for functional nasal surgery, along with preoperative CT and AR. CT-CSAs were assessed in several nasal planes in the first 5 cm of the nasal airway. Area sizes and distances of the CT-CSAs from the columella served to create a CT curve analogous to the AR curve. AR curves were digitized. We examined the correlation and agreement (using the Bland\u2013Altman method) between CT curves and digitized AR curves, as well as between selected CT-CSAs and the first two-encountered AR minimal cross-sectional areas (AR-MCA1 and AR-MCA2). Correlation was investigated by univariate analysis of variance and Pearson\u2019s correlation. Agreement was examined by the Bland\u2013Altman method. Results: In 33 subjects, the correlation of digitized AR with CT was moderate (r = 0.76; p &lt; 0.001). AR, in general, underestimated the actual nasal area by 15%. AR-MCA1 and AR-MCA2 were closest to the CT-CSA of the nasal valve and the incisive canal, respectively. We noted a mainly moderate correlation between the CT-CSA of the nasal valve and AR-MCA1 (all r &gt; 0.59; all p &lt; 0.001) in contrast to the weaker correlations between the CT-CSA of the incisive canal and AR-MCA2. Conclusions: AR may underestimate the actual nasal area by 15%. AR-MCA1 and AR-MCA2 were closest to the CT-CSA of the nasal valve and the incisive canal, respectively.<\/jats:p>","DOI":"10.3390\/diagnostics16020229","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:30:34Z","timestamp":1768203034000},"page":"229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Agreement Between Acoustic Rhinometry and Computed Tomography Nasal Cross-Sectional Areas Perpendicular to the Direction of the Airflow"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4162-4261","authenticated-orcid":false,"given":"Aris I.","family":"Giotakis","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Heppt","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1413-7396","authenticated-orcid":false,"given":"Matthias","family":"Santer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-7234","authenticated-orcid":false,"given":"Martin","family":"Pillei","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering & Management, Management Center Innsbruck, The Entrepreneurial School, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5026-6251","authenticated-orcid":false,"given":"Manuel","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Medical Technologies, Management Center Innsbruck, The Entrepreneurial School, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,11]]},"reference":[{"key":"ref_1","first-page":"191","article-title":"Assessment of nasal obstruction. A comparison between rhinomanometry and nasal inspiratory peak flow","volume":"28","author":"Holmstrom","year":"1990","journal-title":"Rhinology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/all.12778","article-title":"Measurements of nasal airflow and patency: A critical review with emphasis on the use of peak nasal inspiratory flow in daily practice","volume":"71","author":"Ottaviano","year":"2016","journal-title":"Allergy"},{"key":"ref_3","first-page":"151","article-title":"Committee report on standardization of rhinomanometry","volume":"22","author":"Clement","year":"1984","journal-title":"Rhinology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/2045-7022-1-2","article-title":"Diagnostic tools in Rhinology EAACI position paper","volume":"1","author":"Scadding","year":"2011","journal-title":"Clin. Transl. Allergy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1152\/jappl.1989.66.1.295","article-title":"Acoustic rhinometry: Evaluation of nasal cavity geometry by acoustic reflection","volume":"66","author":"Hilberg","year":"1989","journal-title":"J. Appl. Physiol. (1985)"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1152\/jappl.1977.43.3.523","article-title":"Airway geometry by analysis of acoustic pulse response measurements","volume":"43","author":"Jackson","year":"1977","journal-title":"J. Appl. Physiol. Respir."},{"key":"ref_7","first-page":"183","article-title":"External nasal valve collapse\u2014A case-control and interventional study employing a novel internal nasal dilator (Nasanita)","volume":"48","author":"Riechelmann","year":"2010","journal-title":"Rhinology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1055\/s-0031-1281971","article-title":"Substantial dose reduction in modern multi-slice spiral computed tomography (MSCT)-guided craniofacial and skull base surgery","volume":"184","author":"Widmann","year":"2012","journal-title":"Rofo"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4193\/Rhin22.385","article-title":"Ultra-low-dose CBCT: New cornerstone of paranasal sinus imaging","volume":"61","author":"Tamminen","year":"2023","journal-title":"Rhinology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/000348941212100409","article-title":"Correlation of nasal obstruction with nasal cross-sectional area measured by computed tomography in patients with nasal septal deviation","volume":"121","author":"Cho","year":"2012","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/lary.25784","article-title":"Computed tomography scan does not correlate with patient experience of nasal obstruction","volume":"126","author":"Ardeshirpour","year":"2016","journal-title":"Laryngoscope"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/alr.21445","article-title":"Radiographic evaluation of nasal septal deviation from computed tomography correlates poorly with physical exam findings","volume":"5","author":"Sedaghat","year":"2015","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/1945892420950157","article-title":"Rhinomanometry Versus Computational Fluid Dynamics: Correlated, but Different Techniques","volume":"35","author":"Cherobin","year":"2021","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s11548-021-02332-1","article-title":"Agreement between rhinomanometry and computed tomography-based computational fluid dynamics","volume":"16","author":"Berger","year":"2021","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1067\/mhn.2000.105255","article-title":"Acoustic rhinometry and computed tomography scans for the diagnosis of nasal septal deviation, with clinical correlation","volume":"123","author":"Mamikoglu","year":"2000","journal-title":"Otolaryngol. Head. Neck Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/archotol.1997.01900040037006","article-title":"Nasal cavity geometry measured by acoustic rhinometry and computed tomography","volume":"123","author":"Gilain","year":"1997","journal-title":"Arch. Otolaryngol. Head. Neck Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00405-022-07703-1","article-title":"CT analysis of the anterior nasal airway based on the direction of nasal airflow in patients with nasal obstruction and trauma controls","volume":"280","author":"Giotakis","year":"2023","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13005-024-00420-6","article-title":"CT comparison of the nasal airway anterior and posterior to the piriform aperture in patients with and without nasal obstruction","volume":"20","author":"Heppt","year":"2024","journal-title":"Head. Face Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Heppt, H., Widmann, G., Santer, M., Riechelmann, F., Riechelmann, H., and Giotakis, A.I. (2025). Comparison of Cottle-Area-2 and Cottle-Area-3 in Computed Tomography Scans of Patients with Nasal Obstruction and Controls. Diagnostics, 15.","DOI":"10.3390\/diagnostics15111321"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/096228029900800204","article-title":"Measuring agreement in method comparison studies","volume":"8","author":"Bland","year":"1999","journal-title":"Stat. Methods Med. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"141","DOI":"10.11613\/BM.2015.015","article-title":"Understanding Bland Altman analysis","volume":"25","author":"Giavarina","year":"2015","journal-title":"Biochem. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1288\/00005537-199507000-00014","article-title":"Measurements of cross-sectional area of the nasal cavity by acoustic rhinometry and CT scanning","volume":"105","author":"Min","year":"1995","journal-title":"Laryngoscope"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1152\/jappl.2000.89.3.1013","article-title":"Acoustic rhinometry: Validation by three-dimensionally reconstructed computer tomographic scans","volume":"89","author":"Terheyden","year":"2000","journal-title":"J. Appl. Physiol. (1985)"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1046\/j.0908-665x.2001.all.doc.x","article-title":"Objective measurement of nasal airway dimensions using acoustic rhinometry: Methodological and clinical aspects","volume":"57","author":"Hilberg","year":"2002","journal-title":"Allergy"},{"key":"ref_26","first-page":"392","article-title":"Airway area by acoustic response measurements and computerized tomography","volume":"135","author":"Lawson","year":"1987","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_27","unstructured":"Guilmette, R., Wicks, J., Wolff, R., and Mauderly, J. (1992). In Vivo Measurement of Human Nasal Airway Dimensions, ITRI. ITRI Annual Report."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.4103\/picr.PICR_123_17","article-title":"Common pitfalls in statistical analysis: Measures of agreement","volume":"8","author":"Ranganathan","year":"2017","journal-title":"Perspect. Clin. Res."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/2\/229\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:41:32Z","timestamp":1768203692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/2\/229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,11]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["diagnostics16020229"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16020229","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,11]]}}}