The advances in computer technology may increase the validity of classical rhinometric measurements such as acoustic rhinometry and rhinomanometry in parts of the nasal cavities and nasopharynx, which with present knowledge yield unreliable measurement results. Advanced imaging modalities may give us the greatest technological improvements in the immediate future. Double spiral computer tomography scanners make it possible to take images faster, in several planes simultaneously, and give us higher resolution. With the help of image fusion it is possible to perform dynamic imaging. Movable CT/MRI scanners can also make it possible to measure patients in a same position simultaneously with CTV and acoustic rhinometry, thereby diminishing the source of errors when comparisons between the methods are made. CTV and similar methods can be used more often in rhinometric measurements and in evaluation studies in the future, when the techniques and facilities will be faster, cheaper and more easily
CONCLUSIONS
1. Computed tomography volumetry based on semi-automatic segmentation of CT images was tested in nasal airways, and concluded to be an accurate method for rhinometric measurements.
CTV was compared to acoustic rhinometry, and it was concluded that the method was more accurate than acoustic rhinometry and suitable for the evaluation of acoustic rhinometry, but still unpractical for everyday clinical work.
2. The accuracy of acoustic rhinometry was good up to 40 mm, and further posterior the accuracy decreased but remained moderate. The accuracy of minimum cross-sectional areas were much poorer compared to the volumes.
3. A table of the reference ranges for acoustic rhinometry, rhinomanometry and nasal PEF was produced for the clinical work of a local laboratory.
4. The results obtained with acoustic rhinometry, rhinomanometry, nasal PEF, and visual analogue scale are mutually consistent, but the analysis of values did not verify any statistically significant agreement between them. The methods can be seen as mutually complementary.
ACKNOWLEDGEMENTS
This study was carried out at the Departments of Otorhinolaryngology, Head and Neck Surgery, and Diagnostic Radiology at the Tampere University Hospital, at the Ragnar Granit Institute affiliated to Tampere University of Technology, and at the Medical School of the University of Tampere.
First of all I would like to thank my supervisor and teacher, Docent Markus Rautiainen, who introduced me to scientific work and to the topic of rhinometric measurements. His continuous advice and support made it possible for me to complete this work.
I am deeply grateful to Emeritus Professor Heikki Puhakka, former Head of the Department of Otorhinolaryngology, Head and Neck Surgery in Tampere University Hospital for his encouraging attitude, and for providing me with the opportunity to conduct this study.
I owe thanks to Professor Ilmari Pyykkö, Head of the Department of Otorhinolaryngology, Head and Neck Surgery in Tampere University Hospital for helping me to complete the study.
I wish to express my special thanks to Docent Henrik Malmberg and Docent Jukka Sipilä, who officially reviewed the manuscript and gave me valuable and constructive comments.
I am greatly indebted to Heini Huhtala, M.Sc., who provided me with expert statistical guidance during this work.
The co-operation and inspiring discussions with my co-authors in the publications inspired the present study and hopefully also future efforts. I want to thank all of them most cordially.
I would like to thank my colleagues and the personnel at the Department of Otorhinolaryngology for their positive comments, invaluable practical
My sincere thanks are due to Virginia Mattila, M.A., for her fast and skilful revision of the English language of the manuscript.
I would like to express my warmest thanks to the assistance of the Tampere University Hospital Library personnel.
Financial grants from the Medical Research Fund of Tampere University Hospital and the Science Foundation of the City of Tampere are gratefully acknowledged.
I wish to express special thanks to my father, Antti, who has supported me well through these years. I will dedicate this work also to the memory of my loving mother, Netta. Thank You.
Finally, I would like to thank my dear wife, Sari, for her support, her patience all those early mornings and late evenings when I worked at my computer. Thank you for being there for me. My most profound thanks are due to our daughter, Nea, the sunshine of my life. Her hugs and kisses have brightened the bleakest days.
Tampere 1st February 2003
Jura Numminen
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