A novel nasal-to-oral airflow pressure ratio as an objective indicator of nasal obstruction

Objective To introduce and clinically validate, for the first time, a novel nasal-to-oral airflow pressure ratio as an objective metric for assessing nasal obstruction. This ratio is designed to capture compensatory breathing patterns and to improve correlation with subjective symptoms compared with existing assessment methods. Methods A total of 108 patients with self-reported nasal obstruction and 26 healthy controls were enrolled. A custom-designed face mask equipped with pressure sensors recorded nasal airflow pressure during quiet breathing and oral airflow pressure during forced oral breathing. The nasal-to-oral airflow pressure ratio was calculated and correlated with visual analogue scale (VAS) scores for nasal obstruction using Spearman's correlation. Sex-specific subgroup analyses were performed. Results The nasal-to-oral airflow pressure ratio was significantly lower in patients with nasal congestion than in controls (0.13 ± 0.10 vs 0.23 ± 0.12; p 0.001). The ratio showed a strong negative correlation with VAS scores ( ρ = −0.645; p 0.001), outperforming traditional metrics for assessing nasal obstruction. Sex-specific analyses revealed consistent trends in both males and females, with a slightly stronger correlation in female patients. Conclusion This study provides the first clinical validation of the nasal-to-oral airflow pressure ratio as a sensitive, practical, and objective indicator of nasal obstruction. By incorporating compensatory oral breathing dynamics, the ratio bridges the gap between subjective sensation and traditional objective measurements, offering a low-cost, easy-to-deploy tool for broad clinical use.