Position Paper on Nasal Obstruction: Evaluation and Treatment
Por:
Valero, A, Navarro, AM, del Cuvillo, A, Alobid, I, Benito, JR, Colas, C, de los Santos, G, Liesa, F, Garcia-Lliberos, A, Gonzalez-Perez, R, Izquierdo-Dominguez, A, Jurado-Ramos, A, Lluch-Bernal, MM, Gili, JRM, Mullol, J, Casas, P, Sanchez-Hernandez, MC, Vega, F, Villacampa, JM, Armengot-Carceller, M, Dordal, MT
Publicada:
1 ene 2018
Resumen:
Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency.
The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment.
NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to :complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary.
Filiaciones:
Valero, A:
Hosp Clin Barcelona, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Immunoallergia Resp Clin & Expt, Barcelona, Spain
CIBERES Barcelona, Barcelona, Spain
Navarro, AM:
Hosp El Tomillar AGS Sur Sevilla, UGC Alergol, Seville, Spain
del Cuvillo, A:
Hosp Jerez, UGC Otorrinolaringol, Unidad Rinol & Asma, Cadiz, Spain
Alobid, I:
Hosp Clin Barcelona, Unitat Rinol & Clin Olfacte, Barcelona, Spain
Benito, JR:
Hosp Univ Puerto Real, UGC ORL, Unidad Rinol, Cadiz, Spain
Colas, C:
Hosp Clin, Inst Invest Sanitaria Aragon, Zaragoza, Spain
de los Santos, G:
Hosp Univ Ramon y Cajal, Serv Otorrinolaringol, Unidad Rinol & Base Craneo Anterior, Madrid, Spain
Liesa, F:
Hosp Univ Miguel Servet, Zaragoza, Spain
Garcia-Lliberos, A:
Hosp Manises, Secc Rinol, Serv Otorrinolaringol, Valencia, Spain
Gonzalez-Perez, R:
Complejo Hosp Univ Nuestra S Candelaria, Hosp Torax, Unidad Alergia, Santa Cruz De Tenerife, Spain
Izquierdo-Dominguez, A:
Consorci Sanitari Terrassa, Barcelona, Spain
Jurado-Ramos, A:
Hosp San Juan Dios, Cordoba, Spain
Lluch-Bernal, MM:
Hosp La Paz, Serv Alergia, Madrid, Spain
Gili, JRM:
Hosp Santa Cruz & St Pau, Secc Rinol, Serv ORL, Barcelona, Spain
Mullol, J:
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Immunoallergia Resp Clin & Expt, Barcelona, Spain
Hosp Clin & Univ, Serv ORL, Unitat Rinol & Clin Olfacte, Barcelona, Spain
EUFOREA, GA2LEN, CIBERES, Barcelona, Spain
Casas, P:
Hosp Ouiron, Barcelona, Spain
Sanchez-Hernandez, MC:
Hosp Univ Virgen Macarena, UCG Alergol, Seville, Spain
Vega, F:
Hosp Univ La Princesa IP, Hosp Univ Princesa, Inst Invest Sanitaria, Serv Alergia, Madrid, Spain
Villacampa, JM:
Hosp Univ Fdn Jimenez Diaz IDC, Serv Otorrinolaringol & Patol Cervicofacial, Madrid, Spain
Armengot-Carceller, M:
Univ Valencia, Hosp Univ & Politecn Fe, Serv Otorrinolaringol, Valencia, Spain
Dordal, MT:
Badalona Serv Assistencials, Unitat Allergia, Badalona, Spain
St Pere Claver Fundacio Sanitaria, Serv Allergia, Barcelona, Spain
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