Nasal Patency Across Seated, Supine, and Recumbent Postures in Individuals With and Without Allergic Rhinitis

Sheng-Wei Lo; Yao-Te Tsai; Ming-Shao Tsai; Hsin-Yi Tsai; Geng-He Chang

doi:10.1177/01455613241254434

Nasal Patency Across Seated, Supine, and Recumbent Postures in Individuals With and Without Allergic Rhinitis

Ear Nose Throat J. 2024 May 17:1455613241254434. doi: 10.1177/01455613241254434. Online ahead of print.

Authors

Sheng-Wei Lo¹, Yao-Te Tsai^{1

2}, Ming-Shao Tsai^{1

2

3}, Hsin-Yi Tsai¹, Geng-He Chang^{1

2

3

4}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
² Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Head and Neck Infection Treatment Center, Chang Gung Memorial Hospital, Chiayi, Taiwan.

PMID: 38757667
DOI: 10.1177/01455613241254434

Abstract

Objectives: This study aimed to investigate the effects of seated, supine, and recumbent postures on nasal resistance in individuals with allergic rhinitis (AR) and healthy controls, which has not been investigated in the past. Methods: A visual analog scale (VAS) assessed subjective nasal obstruction, while acoustic rhinometry and video endoscopy provided objective measures. Sixty participants, comprising 30 AR patients and 30 healthy controls, were evaluated across 4 postures without decongestion: seated, supine, left recumbent, and right recumbent. Results: In patients with AR, we noted no significant changes in subjective nasal blockage under various postures (all P > .18). However, significant reductions of minimal cross-sectional area (mCSA) were found (seated vs supine, P = .014; seated vs left recumbent, P = .001; seated vs right recumbent, P < .001) and significant increases in the inferior turbinate hypertrophy were observed on the dependent side of the nose when in recumbent posture (right nose: seated vs right recumbent, P = .013; left nose: seated vs left recumbent, P = .003). On the contrary, healthy controls experienced increased subjective nasal obstruction (VAS scores: seated vs supine, P < .001; seated vs left recumbent, P = .003; seated vs right recumbent, P < .001), reductions in mCSA (seated vs supine, P = .002; seated vs right or left recumbent, both P = .001), and increased inferior turbinate hypertrophy on the dependent side of the nose (right nose: seated vs right recumbent, P = .003; left nose: seated vs left recumbent, P = .006). Conclusions: Healthy controls reported better nasal patency when shifting from supine or recumbent to more upright or less gravity-dependent seated postures, which was further supported by objective examinations. On the contrary, despite patients with AR not subjectively perceiving increased nasal patency while adopting more upright postures, objective evaluations demonstrated an improvement in their nasal airflow in these less gravity-dependent postures.Level of Evidence: 4.

Keywords: allergic rhinitis; lateral; nasal obstruction; nasal patency; nasal resistance; position; posture; recumbent; supine.