Position paper on nasal obstruction: evaluation and treatment.

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.

Position paper on nasal obstruction: evaluation and treatment / No disponible

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

La obstrucción nasal (ON) se define como la percepción subjetiva de disconfort o dificultad en el paso del aire a través de las fosas nasales. Es un motivo de consulta frecuente en atención primaria y especializada, que puede afectar hasta un 30-40% de la población. Repercute en la calidad de vida (especialmente con alteración del sueño) y disminuye la eficiencia laboral. El objetivo de este documento es consensuar el manejo de la ON, estableciendo una metodología para su evaluación y diagnóstico y un abordaje individualizado para el tratamiento. La ON puede ser uni o bilateral, intermitente o persistente y debida a factores locales o sistémicos, ya sean anatómicos, inflamatorios, neurológicos, hormonales, funcionales, ambientales o medicamentosos. La anamnesis dirigida y la exploración física son claves para el diagnóstico diferencial. La evaluación de la ON puede realizarse con herramientas de valoración subjetiva (escala visual analógica, puntuación de síntomas, cuestionarios estandarizados) o por estimación objetiva (rinomanometría anterior activa, rinometría acústica, flujo máximo nasal inspiratorio). Aunque existe poca correlación entre ellas, sus resultados pueden considerarse complementarios y no excluyentes. También es aconsejable valorar el impacto en la calidad de vida mediante cuestionarios estandarizados. El tratamiento de la ON se establece en función de la causa. Es fundamentalmente farmacológico (tópico y/o sistémico) cuando la etiología es inflamatoria o funcional. El tratamiento quirúrgico estará indicado tras el fracaso del tratamiento médico, para complementarlo o mejorarlo. Puede ser necesaria la combinación de varias técnicas quirúrgicas y/o la asociación de un tratamiento médico pre/post cirugía