Evaluation of nasalis muscle thickness in patients with nasal obstruction and its relationship with nose score

This study aims to evaluate the changes in the thickness of the transverse part of the musculus nasalis in patients with nasal obstruction and the relationship between these changes and the severity of symptoms. A total of 128 patients over the age of 18 who had been experiencing nasal obstruction for at least three months were included in the study. The patients' demographic data, side of nasal obstruction, and NOSE (Nasal Obstruction Symptom Evaluation) scores were recorded. The thickness of both nasalis muscles was measured using ultrasonography. Based on their NOSE scores, patients were divided into four groups: mild (5–25), moderate (30–50), severe (55–75), and extreme (80–100). According to the data obtained, as the NOSE score increased, there was a significant increase in the thickness of both the right and left nasalis muscles (right: r = 0.291, p = 0.0008; left: r = 0.403, p < 0.0001). In patients with unilateral nasal obstruction, the transverse part of the nasalis muscle on the non-obstructed side was measured to be thicker (right: p = 0.0007; left: p = 0.0343). It was found that male patients had greater nasalis muscle thickness than female patients (right: p = 0.0001; left: p = 0.0075). In our study, the increase in the thickness of the transverse part of the nasalis muscle was found to be associated with the severity of nasal obstruction. Patients with nasal obstruction may be using their facial mimic muscles to open up nasal passages in an effort to alleviate their symptoms. The observation that the muscle thickness increased on both sides may be due to the fact that facial mimic muscles are generally used bilaterally. As the severity of nasal obstruction increases, it is thought that patients use facial expressions more frequently, which in turn increases nasal muscle activity. In line with this, our study also showed a significant increase in the thickness of the transverse part of the nasalis muscle on both sides as the NOSE score increased. The hypertrophy of the muscle on the non-obstructed side, in particular, may be a response to the negative pressure generated in the nasal valve region by increased airflow. In conclusion, our study suggests that not only anatomical but also functional structures should be considered in the evaluation of nasal obstruction. Further studies focusing on nasal muscles may contribute to the diversification and development of treatment models for nasal obstruction.