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Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations

M. Maniscalco, E. Weitzberg, J. Sundberg, M. Sofia, J.O. Lundberg
European Respiratory Journal 2003 22: 323-329; DOI: 10.1183/09031936.03.00017903
M. Maniscalco
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E. Weitzberg
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J. Sundberg
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M. Sofia
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J.O. Lundberg
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  • Fig. 1.—
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    Fig. 1.—

    Schematic presentation of a model resembling the sinus (syringe), the ostium (syringe tip) and the nasal cavity (plastic cylinder). NO: nitric oxide.

  • Fig. 2.—
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    Fig. 2.—

    Original tracing of nitric oxide (NO) during a single-breath nasal exhalation with humming (‐‐‐‐) or silently (––).

  • Fig. 3.—
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    Fig. 3.—

    Effect of repeated humming manoeuvres on nasal nitric oxide (NO) output. Five consecutive exhalations with humming were performed at 5‐s intervals. A progressive reduction in NO output was observed after each manoeuvre until a plateau was reached.

  • Fig. 4.—
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    Fig. 4.—

    Nasal nitric oxide (NO) output measured during a silent exhalation at baseline, immediately after repeated silent nasal exhalations and immediately after repeated humming manoeuvres (five consecutive 10‐s nasal exhalations with humming). #: p=0.002, as compared to baseline, n=6.

  • Fig. 5.—
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    Fig. 5.—

    Change in nasal nitric oxide (NO) output after topical nasal application of an NO synthase inhibitor (l‐NAME). The subjects exhaled either silently (□) or with humming (┘). #: p=0.002, n=6.

  • Fig. 6.—
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    Fig. 6.—

    Influence of ostium size on sinus gas exchange in a sinus/nasal model. A subject performed a single breath exhalation at a fixed flow rate (0.2 L·s−1) either silently (○) or with phonation (•). Sinus gas exchange was calculated by measuring nitric oxide in the syringe before and immediately after each exhalation.

  • Fig. 7.—
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    Fig. 7.—

    The effect of three different humming frequencies (‐‐‐‐: 130 Hz; ––: 150 Hz; ······: 450 Hz) on nitric oxide (NO) output in a sinus/nasal model. A subject exhaled orally in the model at a fixed flow rate of 0.2 L·s−1, a NO concentration of 8 ppm, a resistance of 1cmH2O and an ostium size of 1.9 mm.

Tables

  • Figures
  • Table 1

    Effect of humming frequency on nitric oxide output (nL·min−1) using sinuses with different resonance frequency in the model

    Humming frequencySinus resonance frequency
    120 Hz200 Hz
    120 Hz1043±10527±5.8
    200 Hz561±8.3611±7.7
    400 Hz286±6.3418±8.1
  • Table 2

    The influence of sinus volume, sinus nitric oxide (NO) concentration and flow rate on resulting NO output induced by an artificial pulsating airflow in a model of the nose and sinus with artficial humming

    NO output nL·min−1
    Sinus volume mL
     579±1.0
     10159±4.5*
     15295±3.4*
     20427±3.7*
    NO concentration ppm
     276±1.5
     4162±2.8*
     8295±3.4*
     10434±6.1*
    Flow L·s−1
     0.20295±3.4
     0.25369±5.8*
     0.30411±7.6*
    • *: p<0.05

  • Table 3

    The influence of sinus volume, sinus nitric oxide (NO) concentration and flow rate on resulting NO output induced by human pulsating airflow in a model of the nose and sinus with human humming

    NO output nL·min−1
    Sinus volume mL
     579±1.0
     1087±3.6*
     15175±8.0*
     20242±14.7*
    NO concentration ppm
     257±8.1
     4118±14.6*
     8175±8.0*
     10416±32*
    Flow L·s−1
     0.20175±8.0
     0.25268±4.8*
     0.30356±10*
    • *: p<0.05

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Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations
M. Maniscalco, E. Weitzberg, J. Sundberg, M. Sofia, J.O. Lundberg
European Respiratory Journal Aug 2003, 22 (2) 323-329; DOI: 10.1183/09031936.03.00017903

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Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations
M. Maniscalco, E. Weitzberg, J. Sundberg, M. Sofia, J.O. Lundberg
European Respiratory Journal Aug 2003, 22 (2) 323-329; DOI: 10.1183/09031936.03.00017903
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