Nasal breathing research in Sydney brings together the patient’s experience, the behaviour of the nasal lining and objective measurements of airflow. Our group studies how these elements guide diagnosis and treatment, and how to measure the benefit that patients experience after nasal airway surgery.
Start with the symptom and its mechanism
A useful assessment begins by establishing what a patient means by a blocked or congested nose. Difficulty moving air, pressure and mucus can be described with the same word. The pattern also matters: consistent one-sided obstruction suggests a different problem from blockage that alternates, varies with exposure or becomes worse when lying down.
In Professor Richard Harvey’s clinical approach, the diagnosis connects these symptoms with examination, nasal endoscopy, the response to decongestion and airflow testing. Septal deviation and turbinate enlargement are anatomical findings; identifying fixed narrowing, inflammatory swelling and altered nasal sensation gives those findings clinical meaning. Treatment can then address both the airway and the disease affecting its lining. [1]
Measure the breathing cycle
Rhinomanometry records the relationship between pressure and airflow during breathing. Our research asks how much information is lost when this breathing curve is reduced to a single resistance value.
In a 2026 study of 601 patients, Darbari Kaul and colleagues analysed features of the rhinomanometry curve and compared them with reported nasal obstruction. Curve features correlated more closely with symptoms than resistance measured at 150 Pascals. For the visual analogue symptom score, the correlation was 0.305 for curve features and 0.222 for resistance. The work supports examining the shape of the breathing curve alongside the patient’s account of their symptoms. [2]
Understand the sensation of airflow
The perception of nasal breathing includes the cooling of the nasal lining as air passes over it. This provides a physiological reason to study mucosal function alongside airway dimensions.
Seresirikachorn and colleagues developed endonasal thermal imaging to map temperature changes during breathing. Their 2023 study of 33 patients recorded cooling during inspiration and changes after decongestion. Temperature measurements did not correlate significantly with symptoms or airflow resistance in that cohort. The study established a method for investigating nasal cooling and identified the need for more precise imaging and measurement. [3]
A subsequent prospective study followed seven patients through nasal airway surgery. Symptoms and resistance improved, while the measured thermal variables were similar before and after surgery. Together, these studies define thermal imaging as a research method for understanding nasal sensation and refining how we assess nasal function. [4]
Assess the durability of surgical benefit
Our surgical outcomes research examines relief of obstruction over years, together with healing, medication use and the need for further intervention. This makes the choice of technique a question of sustained function.
Barham and colleagues compared three inferior turbinate techniques in a randomised, blinded study involving 100 patients, with different treatments assigned to the two sides of the nose. At five years, medial flap turbinoplasty had better reported outcomes and fewer revision procedures than the electrocautery and powered submucosal reduction techniques studied. Preserving a mucosal flap while reducing the tissue responsible for obstruction is a distinctive element of this work. [5]
Connect airway treatment with inflammatory disease
Structural correction and treatment of rhinitis belong within the same assessment. Where allergy or inflammation drives fluctuating swelling, the long-term plan needs to address that process as well as any fixed narrowing. This connects our nasal airflow work with chronic rhinosinusitis, allergy and precision treatment.
Explore the research and training program
See the broader research program and publications and our research and academic leadership. Clinicians interested in learning with the group can explore the Sydney observer program and one-year clinical fellowship.
Selected publications and clinical interpretation
1. Harvey RJ. Septal deviation and big turbinates is not a diagnosis. Clinical commentary, 2026.
2. Darbari Kaul R, et al. Correlation of Patient-Reported Symptoms With Rhinogram Features Beyond Simple Airway Resistance. Ann Otol Rhinol Laryngol. Published online 2026.
3. Seresirikachorn K, et al. Endonasal thermal imaging in the assessment of nasal obstruction and airflow. Australian Journal of Otolaryngology. 2023.
4. Seresirikachorn K, et al. Endonasal Thermal Imaging Before and After Nasal Airway Surgery. Ann Otol Rhinol Laryngol. 2025;134:21–30.
5. Barham HP, et al. Long-term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction. Int Forum Allergy Rhinol. 2016;6:143–147.