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Cancer of the nasal cavity: survival and factors influencing prognosis.

OBJECTIVE: To determine overall survival and prognostic factors for cancer of the nasal cavity. DESIGN: Cross-sectional analysis of a national cancer database. METHODS: All cases of nasal cavity cancer were extracted from the Surveillance, Epidemiology and End Results database for 1988 through 1998. Cases with distant metastatic disease were excluded. Tumor histologic types, TNM staging, and pathological features were computed. Kaplan-Meier and Cox proportional hazards analyses were conducted to determine factors influencing overall survival. RESULTS: A total of 981 cases were identified, with 3.5% presenting with distant metastatic disease. After exclusion of missing variables, 783 cases were analyzed, with a mean patient age of 63.8 years. Squamous cell carcinoma was the most common tumor histologic type (49.3%), followed by esthesioneuroblastoma (13.2%). More than half of the cases presented with early (T1) primary site disease, and only 5% had positive nodal disease at presentation. Overall mean (median) survival was 76 (81) months, with an overall 5-year survival rate of 56.7%. On multivariate analysis, male sex, increasing age, T stage, N stage, and poorer tumor grade independently adversely affected survival (P<.05). Radiotherapy was administered in 50.5% of patients and also independently predicted poorer survival (P =.03). The mean (median) survival for squamous cell carcinoma was 79 (84) months; only melanoma showed a statistically significantly poorer mean survival of 40 (30) months when compared with other tumors (P<.001). CONCLUSIONS: Age, sex, and staging variables have a significant prognostic impact in nasal cavity cancer. Melanomas of the nasal cavity manifest very poor survival.

Age Factors↗

[Multivariate analysis of prognosis of patients with stage IE non-Hodgkin's lymphomas of the nasal cavity].

OBJECTIVE: To analyze the factors affecting prognosis of patients with primary non-Hodgkin's lymphomas (NHL) of the nasal cavity. METHODS: From Jan. 1968 to Dec. 1997, a total of 71 patients with stage IE(Ann Arbor staging system, 1971) primary non-Hodgkin's lymphomas of the nasal cavity were treated in the Tumor Hospital of Sun Yat-sen University of Medical Sciences. In 37 of the 71 patients, the lesions were limited in the nasal cavity (limited IE), and in 34, the lesions were locally extended involving the adjacent structures (extended IE) Forty-four patients were treated with radiotherapy and 27 with radiotherapy plus chemotherapy. Survival analysis was done by the Kaplan-Meier method, and multivariate analysis was carried out using Cox proportional hazard model. RESULTS: The 5- and 10-year survival rate was 71.9% and 59.7% respectively in patients who had complete response to radiotherapy. The 5- and 10-year survival rate was both 13.9% in patients who had residual tumors after treatment. The 5- and 10-year survival rate was 69.8% and 56.7% in patients with limited IE lesions, but 40.7% and 35.6% in those with extended IE lesions. The prognosis was better in younger (< 44 years) than in older patients. The 10-year survival rate of patients received radiotherapy alone and those combined with chemotherapy was 52.0% and 75.0% respectively for limited IE as compared to 37.6% and 45.0% for extended IE. B symptoms did not significantly affect clinical outcome. Multivariate analysis showed that the immediate response to radiotherapy, invasion of the primary tumor outside of nasal cavity and patients' age were independent prognostic factors. CONCLUSION: Radiotherapy is the main treatment method for stage IE non-Hodgkin's lymphoma of the nasal cavity. Addition of chemotherapy can improve long-term survival. The local tumor response to radiotherapy, clinical staging and age of patients have significant influence on patients' prognosis.

Adolescent↗

[Neurinoma of the nasal cavity].

A 35 years old male patient presented with serous nasal secretion, relapsing epistaxis and a slowly progredient nasal obstruction. Clinical examination and CT scans showed a tumor occupying the left middle meatus and the whole nasal cavity displosing the nasal septum to the right side. The tumor was resected by a midfacial degloving approach. Histological examination showed a neurinoma. By means of the presented case report and a review of literature, diagnosis and treatment of this rare nasal tumor are discussed.

Adult↗

[Clinical analysis of 48 cases sarcoma in nasal cavity and sinuses].

OBJECTIVE: To enhance the level of diagnose and treatment of sarcoma in nasal cavity and sinuses by studying the clinical features, diagnosis and treatment of 48 cases sarcoma in nasal cavity and sinuses. METHOD: Forty-eight cases sarcoma in nasal cavity and sinuses treated from 1995 to 2000 were analyzed retrospectively. RESULT: Fibrosarcoma in 4 cases, malignant fibrous histiocytoma in 3 cases, liposarcoma in 4 cases, leiomyosarcoma in 5 cases, rhabdomyosarcoma in 5 cases, osteosarcoma in 2 cases, chondrosarcoma in 3 cases, malignant melanoma in 4 cases, non-Hogkin's in 4 cases, extramedullary plasmacytoma in 1 case, Schwannoma in 5 cases, esthesioneuroblastoma in 5 cases, angiosarcoma in 3 cases. Following-up after synthetic treatment, the 1, 3, 5 year survival rates were 62.5%, 46.7%, 35.7% respectively. CONCLUSION: Sarcoma in nasal cavity and sinuses is not easy to diagnose definitely, immunohistochemistry is helpful for pathological diagnose. It's easy to recurrent and metastasis and it's beneficial to improve prognosis with synthetic treatment.

Adolescent↗

[The early development of Jacobson's organ in the nasal cavity of the rat before the inception of the secondary palatal development].

The early development of Jacobson's organ was studied by means of a series of embryos of the rat which were of various ages and exactly dated. Already at the youngest stage of those rats, the nasal cavity is just an open groove, the organ is a thickened epithelial layer at the medial nasal process. Only 15 h later, while the nasal grooves start to close from caudal to rostral, Jacobson's organ has acquired the shape of a deep, long cleft, situated within the broad nasal opening. On the 13th d of fetal life, a complete, caudally closed nasal cavity appears. By the means of fundamental growth changes, the already well developed organ has become shifted to a more caudal position and lies now above the primary palate. A shorter caudal part of the still cleft-like organ just starts to close itself thus forming its typical tube-like structure. Moreover strong nerve bundles running from Jacobson's organ to the brain indicate that in the meantime a sensory epithelium can be distinguished. Up to the 15th d of development, the tube-forming process of Jacobson's organ is completed. Parallel to this procedure, the surrounding nasal cavity acquires a caudal apertura nasalis interna by the rupture of the membrana bucconasalis while Jacobson's organ still lies above the rostral primary palate. Primary in the medial, somewhat later in the lateral part of the nasal cavity, first outlines of cartilage appear, visible as dense cell formations. Together with this, the paraseptal cartilage, in these stages closely connected to the septal cartilage, develops quite early. Between the 14th and 15th d of its fetal life, the flat, tube-formed Jacobson's organ of the rat gets turned from a primary horizontal into a vertical position, which brings its sensory epithelium to the medial side. It is assumed that this happens for functional reasons. Because of the obviously early and progressive development of Jacobson's organ within that of the nasal cavity, it seems to be probable that already the origin of the nose, the olfactory placodes, are determined in the directions both of the nasal cavity and of Jacobson's organ. Furthermore the results demonstrate an early preferential development of Jacobson's organ in comparison to that of the surrounding nasal cavity.

Animals↗

Determination of surface areas, volumes, and lengths of cynomolgus monkey nasal cavities by ex vivo magnetic resonance imaging.

We have used high-resolution three-dimensional magnetic resonance imaging (MRI) to measure the surface area, volume, and length of the nasal cavities of cynomolgus monkeys (10 male, six female) over a range of body weights (1.9-5.3 kg, mean 2.9 kg) and ages (8-45 months, mean 30.0 months). The measurements were carried out ex vivo on formalin-fixed, decalcified nasal cavities filled with water. Mean (standard deviation) values were 30.2 (7.2) cm(2), 2.33 (0.65) cm(3), and 3.34 (0.44) cm, respectively. Linear regression least squares best fits provide the following empirical relationships: Nasal cavity surface area (SA, cm(2)) as a function of body weight (BW, kg): SA = 15.1 + 5.1(BW), R = 0.84 Nasal cavity volume (V, cm(3)) as a function of body weight: V = 1.15 + 0.4(BW), R = 0.74 Nasal cavity length (L, cm) as a function of body weight: L = 2.43 + 0.31(BW), R = 0.84 The left and right sides of the cavity were symmetrical in both males and females and showed little anatomical variation between individuals. The perimeter of the nasal cavity was maximal at about 60% of its extent from the nares. These data can aid in extrapolating nasal dosimetric exposure indices from cynomolgus monkeys (1.9-5.3 kg) to other species.

Animals↗

Acoustic rhinometry: accuracy and ability to detect changes in passage area at different locations in the nasal cavity.

OBJECTIVES: To evaluate the accuracy of acoustic rhinometry (AR) measurements, and to assess how well AR detects obstructions of various sizes at specific sites in the nasal cavity, we created a cast model from an adult cadaver nasal cavity. METHODS: The actual cross-sectional areas of the cast model nasal passage were determined by computed tomography and compared with the corresponding areas measured by AR. To assess how nasal obstruction affects the AR results, we placed small wax spheres of different diameters at specific sites in the model (nasal valve, head of the inferior turbinate, head of the middle turbinate, middle of the middle turbinate, choana, and nasopharynx). RESULTS: The AR-derived cross-sectional areas in the first 6.5 cm of the cast model nasal cavity were very close to the corresponding areas calculated from computed tomographic sections perpendicular to the presumed acoustic axis. However, AR overestimated the passage areas at locations posterior to the 6.5-cm point. Acoustic rhinometry gave an accurate indication of the passage area of the nasal valve and its distance from the nostril. The nasal valve and the choana were indicated by significant dips on the AR area-distance curve, whereas the curve was smooth throughout the region that included the head of the inferior turbinate, the head of the middle turbinate, the middle of the middle turbinate, and the nasopharynx. In other words, AR did not discretely identify these latter sites. Acoustic rhinometry detected the different-sized inserts (obstructions) more accurately at the nasal valve than at sites posterior to this location. CONCLUSIONS: The results of the study show that AR is a valuable method for assessing the anterior nasal cavity. This technique is sensitive for detecting changes in passage area at the nasal valve region; however, the sensitivity is lower at sites posterior to this. The findings suggest that when there is substantial narrowing of the nasal valve, AR will not identify an obstruction at any location posterior to the nasal valve. In such situations, AR measurements beyond the abnormal nasal valve may easily lead to misinterpretation of the patient's nasal anatomy or condition.

Cross-Sectional Studies↗

Metastatic melanoma of the nasal cavity in a patient with oculocutaneous albinism.

The nasal cavity is a rare location for primary malignant melanoma, borne out by the few cases reported in the literature since 1940. Rarest of all is nasal melanoma in a patient with oculocutaneous albinism. An albino subject, aged 33, was referred to us with this diagnosis. Because of the numerous metastases in the liver and left lung, we did not advise radical surgical intervention and, despite hyperfractionated high dose radiotherapy and chemo-immunotherapy, the advanced stage of disease caused the death of the patient within a year. We have reviewed the diagnostic, clinical and therapeutic aspects, and the literature on melanomas of the nasal cavity in albino subjects. We performed a Medline literature search, examining only 'extensive' papers and excluding abstracts or case reports presenting poor data.

Adult↗

[Influence of the angle between the nasal cavity axis and nosepiece in acoustic rhinometry].

We evaluated the influence of the angle between the nasal cavity axis and the nosepiece (made with acrylics) in acoustic rhinometry (AR). This study was composed of three experiments. In the first experiment, the influence of angulation on nasal volume was evaluated using a silicone nasal model based on a cast of the nasal cavity of a cadaver. The angle between the nosepiece and the horizontal plane was changed by 10 degrees, 40 degrees or 70 degrees, vertically; the angle between the nosepiece and the sagittal plane was similarly changed horizontally. The nasal volume, obtained as the AR area-distance curve from 6.9-14.1cm, was measured under each condition. While the horizontal change in angle did not significantly influence the result obtained by AR, in the vertical change, the measured value rose as the angle was decreased from 70 degrees to 10 degrees. In the second experiment, an evaluation in healthy subjects (5 males, 4 females, mean age 28.6 years) revealed the same tendency in changing the horizontal angle, whereas vertically a change of 10 degrees produced a significant decrease over that seen with angles of 40 degrees and 70 degrees. This result contradicted that obtained in the model study mentioned above. In studying the effect of changing the vertical angle, the volume of the posterior 5 cm and that of the anterior 2 cm of the nasal cavity was evaluated in the same subjects. The volume of the posterior 5 cm did not differ significantly among angles, while that of the anterior 2 cm showed the same trend as observed with the whole nasal cavity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Primary malignant melanoma of the nasal cavity: a clinicopathologic study of nine cases.

Nine cases of primary malignant melanoma of the nasal cavity are presented. All the patients had epistaxis and nasal obstruction at admission. Gross aspect of the neoplasia showed a fungating mass located in the right nasal cavity in six cases and in the left nasal cavity in three. Eight tumors were formed by polygonal cells and one tumor by spindle cells. Melanosis of the adjacent mucosa was found in only 1 case. S-100 protein was demonstrated by indirect immunoperoxidase in all cases. The mean survival rate was 23.8 months. Prognosis was not related to the histologic pattern, cell atypia, necrosis, pigment secretion, or mitotic index. Radiotherapy seemed to have some beneficial influence on the survival but did not influence the local recurrence and metastatic spread of the disease.

Aged↗

Nasal cavity dimensions in the newborn measured by acoustic reflections.

The acoustic reflections technique was used to measure nasal cavity dimensions in 27 newborns. The results were expressed in terms of curves describing cross-sectional area as a function of the distance into the nose. From these curves, a mean curve with 95% confidence limits, nasal cavity volumes between the nostril and 4.5 cm into the nasal cavity (V45 = 1.05 (0.24) cm3), the cross-sectional area at the narrowest site (Amin = 0.114 (0.033) cm2), and the distance from the nostril to Amin (DAmin = 1.14 (0.47) cm), expressed as mean and SD were calculated. There was a weak correlation between Amin and length and weight at birth, but otherwise nasal cavity dimensions did not correlate with sex, race, birth weight, birth length, head circumference, or duration of gestation. Comparison of the curves from the newborns with curves from adults showed a facial growth in vertical/transverse directions (area) of 600% and anterior/posterior directions of 120%. The technique of acoustic rhinometry is noninvasive, and can be performed rapidly, and is therefore eminently suitable for pediatric application. Further investigations are needed to demonstrate the value as a diagnostic tool in pathological cases.

Acoustics↗

[Fourteen cases of malignant melanoma of the nasal cavity].

Fourteen cases of malignant melanoma of the nasal cavity were treated in our department during 31 years from 1962 to 1993. Ten were males and 4 were females. The ages ranged from 48 to 92 years old, with an average of 64.6 years. The chief complaints were epistaxis in 10 cases, nasal obstruction in 7, nasal cavity tumor in 1, and dull headache in 1. Histologically, 3 cases were amelanotic type, 3 oligomelanotic and 8 melanotic. The cellular types were classified as follows: 5 spindle and 9 large epitheloid cell types. Palliative treatment was performed in 1 patient, and 13 patients were treated radically. Local recurrences were seen in 8 patients, 9 regions; 3 near the posterior margin, 1 near the upper margin, 1 cheek, 2 ethmoid sinus, 1 maxillary sinus, and 1 uncertain. The cumulative survival rate among the 14 patients was 54.2% after 2 years and 31.0% after 5 years. One patient had local recurrence 13 years after surgical treatment.

Aged↗

[Primary non-Hodgkin's lymphoma of the nasal cavity at early stage: long-term treatment outcomes and prognostic analyses of 108 cases].

BACKGROUND & OBJECTIVE: Primary non-Hodgkin's lymphoma (NHL) of the nasal cavity has unique clinicopathologic features, and optimal treatment regimen remains unclear. This study was to summarize the clinical features, treatment outcomes, and prognostic factors of primary NHL of the nasal cavity at early stage. METHODS: Records of 108 patients with primary NHL of the nasal cavity, consecutively treated at Cancer Center, Sun Yat-sen University from Jun. 1990 to Sep. 2004, were reviewed. All diagnoses were confirmed with pathology and immunochemistry. Seven cases were of B-cell phenotype. Survival prognostic factors were analyzed by Kaplan-Meier method and Cox regression model with SPSS12.0 software. RESULTS: Median follow-up time for survived patients was 41 months. The overall complete remission (CR) rate after primary treatment was 67.6%, and CR rates were 80.2% for the patients received radiochemotherapy and 29.6% for the patients received chemotherapy alone. There were evidences indicating systemic relapse in 33 (30.6%) patients. With regard to the control of local, regional, and systemic failure, radiochemotherapy was better than chemotherapy alone. The 5-year overall survival rate was 50.0% for all patients. Both univariate analysis and multivariate analysis showed that pre-treatment history of more than 3 months, primary lesion limited in the nasal cavity, CR after primary treatment, and radiochemotherapy were favorable prognostic factors. CONCLUSIONS: Nasal cavity is frequently involved by peripheral T- and NK-cell lymphomas. Pre-treatment history of disease, extent of primary lesion involvement, and response to the primary treatment may be independent prognostic factors.

Adolescent↗

Lectin histochemical study on the olfactory organ of the newt, Cynops pyrrhogaster, revealed heterogeneous mucous environments in a single nasal cavity.

Expression patterns of glycoconjugates were examined by lectin histochemistry in the nasal cavity of the Japanese red-bellied newt, Cynops pyrrhogaster. Its nasal cavity consisted of two components, a flattened chamber, which was the main nasal chamber (MNC), and a lateral diverticulum called the lateral nasal sinus (LNS), which communicated medially with the MNC. The MNC was lined with the olfactory epithelium (OE), while the diverticulum constituting the LNS was lined with the vomeronasal epithelium (VNE). Nasal glands were observed beneath the OE but not beneath the VNE. In addition, a secretory epithelium was revealed on the dorsal boundary between the MNC and the LNS, which we refer to as the boundary secretory epithelium (BSE) in this study. The BSE seemed to play an important role in the construction of the mucous composition of the VNE. Among 21 lectins used in this study, DBA, SBA and Jacalin showed different staining patterns between the OE and the VNE. DBA staining showed remarkable differences between the OE and the VNE; there was intense staining in the free border and the supporting cells of the VNE, whereas there was no staining or weak staining in the cells of the OE. SBA and Jacalin showed different stainings in the receptor neurons for the OE and the VNE. Furthermore, UEA-I and Con A showed different stainings for the nasal glands. UEA-I showed intense staining in the BSE and in the nasal glands located in the ventral wall of the MNC (VNG), whereas Con A showed intense staining in the BSE and in the nasal glands located in the dorsal and medial wall of the MNC (DMNG). The DMNG were observed to send their excretory ducts into the OE, whereas no excretory ducts were observed from the VNG to the OE or the VNE. These results suggested that the secretion by the supporting cells as well as the BSE and the DMNG establishes that there are heterogeneous mucous environments in the OE and the VNE, although both epithelia are situated in the same nasal cavity.

Animals↗

Physiologically based modeling of vinyl acetate uptake, metabolism, and intracellular pH changes in the rat nasal cavity.

Chronic inhalation exposure to vinyl acetate (VA) causes lesions in the nasal cavity of the rat. This effect appears to be related to tissue exposure to either acetaldehyde (AAld) or acetic acid (AA) metabolites of VA or both. A physiologically based pharmacokinetic model was constructed to describe the deposition of VA in the nasal cavity of the rat and provide estimates of regional tissue exposure to VA, AAld, and AA. Since formation of AA in the nasal tissue should cause intracellular acidification, a submodel which describes free intracellular hydrogen ion concentration and intracellular pH (pHi) changes was linked to the VA model. The dosimetry model was applied to data from a series of experiments designed to measure the uptake and metabolism of VA in the isolated upper respiratory tract of the rat at exposure concentrations ranging from 73 to 2190 ppm. Extraction of VA from the nasal cavity was nonlinear with respect to exposure concentration and ranged from 36 to 94%, with the greatest deposition occurring at the lowest VA concentrations. Pretreatment with bis(p-nitrophenyl)phosphate, an inhibitor of carboxylesterases, significantly reduced fractional deposition of VA compared to naive rats exposed to similar VA concentrations. The best model fits for VA extraction and AAld appearance were achieved when a second carboxylesterase isozyme, with high-affinity characteristics, was included. Simulations of 6-h inhalation exposures to VA predicted that the order of nasal tissue exposures will be to AA > AAld > VA. In addition, based on measured tissue hydrolysis rates, sufficient acid should be formed by the metabolism of VA to cause significant changes in pHi. VA exposures of 200 and 600 ppm were predicted to result in a pHi of less than 7.2 and 6.7, respectively. This model provides nasal dosimetry estimates needed to develop mechanistically based risk assessment approaches for human exposures to VA vapor.

Acetaldehyde↗

Light microscopic study of blood vessels of the nasal cavity of the pig.

4 adult pigs were used for light microscopic studies to depict the relationship between nasal blood vessels and the surface epithelium, and to describe the histomorphology of these vessels. After giving an electric shock, animals were bled to death. Tissues were collected from three regions in the nasal cavity after splitting heads sagitally. Different types of vessels were described and a new classification was suggested. Arteries were muscular in type with, as well as without, internal elastic laminae. Thick-walled veins (characterized by smooth muscle cells in the tunica media) were present throughout the nasal cavity, while thin-walled veins or cavernous spaces were discernible only in the caudal one third of the nasal cavity. Further, arteriovenous anastomoses, epithelioid arterioles, and free smooth muscle cells in the propria submucosa were observed throughout the nasal cavity.

Animals↗

[Dynamic imaging of the nasal cavity and the paranasal sinuses with polarized 3helium MRI].

PURPOSE: Reduced or blocked ventilation of the paranasal sinuses is probably the most important factor in the development of sinusitis. Recently, the use of optically polarized noble gas isotopes has attracted increasing interest for use in a variety of promising MR applications. The aim of this study was to test the feasibility of imaging and visualization ventilation of the nasal cavity and paranasal sinus in MR by inhalation of hyperpolarized (3)helium. The goal was to evaluate ventilation defects of the paranasal sinuses. VOLUNTEERS AND METHODS: Three volunteers were enrolled in the study. (3)Helium was polarized to 40 - 50 % by direct optical pumping. 300 ml of 100 % (3)helium were administered in the left nasal vestibule through a glass tube. With a closed contralateral nasal vestibule, the Valsalva maneuver was performed twice. Using a dedicated application unit, which is also used in MR imaging of the lung, an exact amount of (3)helium gas was administered at the beginning of inspiration. Measurements were carried out on a clinical 1.5 T scanner. Coronal images of the nasal cavity and paranasal sinuses were acquired using ultrafast gradient-echo pulse sequence (TR = 2 ms, TE = 0.7 ms, FA < 2 degrees, 75 x 128, FOV = 500) with an image aquisition time of 130 ms. RESULTS: The oral cavity and nasal cavities display a very high signal intensity after inhalation of polarized (3)helium gas. The signal intensity in the left maxillary sinus was higher compared to the right one. The mean signal intensity on the left side was 526 +/- 86 and on the right side 336 +/- 102. The left and right frontal sinus and ethmoid sinus only show signal of hyperpolarized (3)helium after two Valsalva maneuvers. Because of the low signal intensity of the frontal and ethmoid cells their visualization was incomplete. The signal to noise ratio was 14.1 for the left maxillary sinus, 8.9 for the right side, 6.3 for the left ethmoid sinus, 5.8 for the right side and 6.6 for the left frontal sinus and 7.8 for the right side. CONCLUSION: (3)Helium MR allows imaging of the nasal cavity and the paranasal sinuses. Perhaps this method could be a new tool to visualize the ventilation of the maxillary sinus without ionizing radiation. Interpretations about the ventilation of the frontal and ethmoid cells remain speculative.

Administration, Inhalation↗

Velocity profiles measured for airflow through a large-scale model of the human nasal cavity.

An anatomically accurate, x20 enlarged scale model of a healthy right human adult nasal cavity was constructed from computerized axial tomography scans for the study of nasal airflow patterns. Detailed velocity profiles for inspiratory and expiratory flow through the model and turbulence intensity were measured with a hot-film anemometer probe with 1 mm spatial resolution. Steady flow rates equivalent to 1,100, 560, and 180 ml/s through one side of the real human nose were studied. Airflows were determined to be moderately turbulent, but changes in the velocity profiles between the highest and lowest flow rates suggest that for normal breathing laminar flow may be present in much of the nasal cavity. The velocity measurements closest to the model wall were estimated to be inside the laminar sublayer, such that the slopes of the velocity profiles are reasonably good estimates of the velocity gradients at the walls. The overall longitudinal pressure drop inside the nasal cavity for the three inspiratory flow rates was estimated from the average total shear stress measured at the central nasal wall and showed good agreement with literature values measured in human subjects.

Adult↗