Intranasal Volume Increases with Age

Does intranasal cavity volume increase with age, and is it related to body mass index (BMI)?

Bottom Line
Intranasal volume increases approximately linearly with age in adults. This study demonstrates that intranasal volume is larger in males than in females in the same age group, but is not related to BMI. It is likely that the larger intranasal volumes in males versus females relates to the overall larger size of males, but is not related to BMI, as there is no fatty tissue in the nasal cavity.

Background: Although many studies have described changes in the external nose with age, few have focused on intranasal changes. The study researchers used volumetric analysis of CT scans to demonstrate a significant change in intranasal volume with increasing age.

Study design: Retrospective chart review.

Setting: Department of Otolaryngology–Head and Neck Surgery, Emory University, Atlanta, Ga.

Synopsis: Patients were chosen based on age from a database of 11,000 neck computed tomography (CT) scans performed between October 2010 and July 2014 for nonsinonasal complaints. Patients were chosen from three different age groups: age 20 to 30 years (group 1), 40 to 50 years (group 2), and 70 years and older (group 3). Vitrea software (Vital Images, Inc., Minnetonka, MN) was used to form three-dimensional images of the total intranasal volume using the axial, coronal, and sagittal images in the bone algorithm and lung window. Volumes were measured from the nasal vestibule anteriorly, the nasopharynx posteriorly, the olfactory cleft superiorly, and the nasal floor inferiorly.

Sixty-two CT scans were analyzed: 22 from the 20 to 30-year-old group, 20 from the 40 to 50-year-old group, and 20 from the 70-year-old and older group. The mean intranasal volume in group 1 was 15.73 mL (14.59 mL for females, 17.10 mL for males). The mean intranasal volume in group 2 was 17.30 mL (15.23 mL for females, 19.07 mL for males). Mean intranasal volume for patients with a BMI lower than 25.0 kg/m2 was 16.55 mL, and for patients with a BMI of 25 kg/m2 or higher was 17.60 mL.

The authors state that their data demonstrate a progression of increasing nasal volume with each successive age group (20–30 years = 15.73 mL, 40–50 years = 17.30 mL, and 70 years and older = 18.38 mL). This study differed from previous studies in that these researchers used CT volumetric analysis to calculate nasal volumes. Additionally, CT volumetric analysis of the entire nasal cavity (i.e., sum of left and right sides) removes the effect of anatomic variations, such as deviated nasal septum, concha bullosa, and other asymmetries, as compared with unilateral measurements. Because the entirety of the nasal cavity should be equally affected by the changes with age, the authors said that this is a more accurate method of measurement, eliminates the subjective issue of airflow perception, and does not require patient participation.

Citation: Loftus PA, Wise SK, Nieto D, Panella N, Aiken A, DelGuadio HM. Intranasal volume increases with age: computed tomography volumetric analysis in adults. Laryngoscope. 2016;126:2212–2215.