Evaluation of Mini Infrared Thermographic Camera as an Objective Tool for Assessment of Nasal Obstruction, A Feasibility Study

Abstract

Nasal Obstruction (NO) is a common symptom for a wide range of pathologies, to date there are no universally accepted methods to determine the severity of NO. Nasal Obstruction can be evaluated subjectively by means of questionnaires such as Nasal Obstruction Symptom Evaluation (NOSE) and Visual Analog Scale (VAS). Objective methods of evaluation include Anterior-Posterior Rhinomanometry, acoustic rhinometry, Peak Nasal inspiratory Flow and 3D CT reconstruction flow modeling. This study explores a novel method of NO severity evaluation, by means of Mini Infrared (IR) Thermographic Camera. Inspired air has a cooling effect on nasal vestibule skin while expired air conversely warms up the skin. The cooling and warming process emits Infrared wavelengths at different intensities hence an Infrared camera can be used to indirectly measure the temperature fluctuation without direct contact. This study primarily compares Nasal Vestibule temperature fluctuation range detected on mini IR thermographic camera to NOSE questionnaire score in subjects with the symptom of Nasal Obstruction. Secondarily, this study compares IR thermography results to standard measurement of Active Anterior Rhinomanometry. 34 Subjects with Nasal Obstruction complaints were recruited from the outpatient clinic. All subjects are required to complete the survey via NOSE questionnaire, then to undergo IR thermography evaluation and Anterior Rhinomanometry in the same setting. All subjects are above the age of 18 and well consented. Exclusion criteria includes underlying lung disease, local nasal skin inflammatory condition, septal perforation and recent nasal surgeries. Result wise there is a moderately strong correlation found (R2 = 0.713), between NOSE score and Nasal Vestibule Temperature Fluctuation Means ; On the other hand, Correlation between Nasal Vestibule Temperature Fluctuation and Anterior Rhinomanometry is weak (R2 = 0.001 - 0.008). In conclusion Infrared camera is a potentially useful tool for evaluation of Nasal blockage, demonstrated by moderate correlation to the subjective NOSE score, however further study with larger sample size is needed for validation.