Rhinology and Sleep Medicine

This research stream focuses on nasal, sinus, airway and sleep-breathing conditions, including chronic rhinosinusitis, nasal obstruction, airflow assessment and personalised treatments.

Project leads

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Mr Umar Rehman, BMBS, MSc, BSc, PGCME, MRCS (Eng)

PhD Student and Clinical Research Fellow

UCL Cancer Institute

Portrait photo of Dr Manuel Birlo
Dr Manuel Birlo, PHD

Research Fellow

Department of Targeted Intervention

Why this matters 

Nasal and sinus disease can have a major impact on daily functioning, sleep, wellbeing, and quality of life. Symptoms such as nasal blockage, impaired airflow, facial pressure, recurrent infections, and disturbed sleep can be difficult to measure using clinical examination alone. 

By combining patient-reported symptoms with objective assessment, biological sampling, and clinical outcome measures, we aim to improve diagnosis, treatment selection, and long-term care. 

Our aims 

We aim to: 

  • Improve treatment pathways for chronic rhinosinusitis and related nasal conditions.
  • Better understand nasal inflammation through cytokine, proteomic, and biological sampling approaches.
  • Improve how nasal airflow is measured before and after medical or surgical treatment.
  • Compare objective airflow measures with patient-reported symptoms.
  • Support more personalised treatment decisions in rhinology and sleep-related nasal obstruction.
  • Advance innovation in rhinoplasty and facial plastic surgery training.  

Key research areas 

Chronic rhinosinusitis 

Our team contributed to national research on chronic rhinosinusitis, including the MACRO trial exploring treatment effectiveness. We are now focusing on nasal cytokines, proteomics, and personalised treatment approaches in chronic rhinosinusitis and related sinonasal conditions. 

This work aims to help identify which patients are most likely to benefit from specific treatments and to improve long-term outcomes for people with chronic nasal and sinus disease. 

Nasal airflow assessment 

We are interested in improving how nasal airflow is measured before and after treatment, including nasal and sinus surgery. 

Accurate assessment of nasal airflow is important because symptoms of nasal blockage do not always match what can be seen on examination alone. By combining patient-reported symptoms with objective airflow measurements, we aim to better understand the functional impact of nasal obstruction and how this changes after surgery. 

Facial plastic surgery and rhinoplasty training 

We are involved in surgical education research, including the use of validated 3D models to support rhinoplasty training. 

This provides trainees with a safe and realistic way to develop surgical skills, supporting innovation in facial plastic surgery education and patient safety. 

Key focus 

  • Measuring nasal airflow before and after surgery.
  • Comparing objective airflow measures with patient-reported symptoms.
  • Understanding how surgery changes nasal function.
  • Supporting more personalised treatment decisions.
  • Improving outcome assessment in rhinology, sleep medicine, and facial plastic surgery.
  • Education in facial plastic surgery
  • Development of PROMS in facial plastic surgery.  

Why it matters 

Reliable nasal airflow assessment can help clinicians evaluate treatment benefit more accurately, guide patient counselling, and support research into better treatments for nasal obstruction and sleep-related breathing problems. 

Impact 

This stream aims to improve diagnosis, monitoring, treatment selection, and patient care for people with nasal, sinus, airflow, sleep-related, and facial plastic surgery conditions. 

Key publications

  1. Lechner M, Fjaeldstad A, Rehman U … Boardman J, et al. The Development and Validation of the Smell-Qx Questionnaire, Based on a Systematic Review of the Literature and the COMET Initiative on the Development of Core Outcome Sets for Clinical Trials in Olfactory Disorders. Int Forum Allergy Rhinol. 2025 Sep;15(9):974-984.
  2. Patel ZM, Holbrook EH, Turner JH … Lechner M, et al. International Consensus Statement on Allergy and Rhinology: Olfaction. Int Forum Allergy Rhinol. 2022 Apr;12(4):327-680. Erratum in: Int Forum Allergy Rhinol. 2023 Sep;13(9):1844.
  3. Rehman U, Ahn Y, Yerushalmi E … Hafner M, Lechner M. Neglected burden of obstructive sleep apnoea: workplace productivity loss in the USA and UK. Thorax. 2026 Apr 16;81(5):492-494.
  4. Rehman U, Polglase N, Kahn D … Eynon-Lewis N, Lechner M. Bridging the Gap in Rhinoplasty Training: The Effectiveness of 3D-Printed Models in Surgical Education. Aesthet Surg J. 2025 Jun 16;45(7):655-661.
  5. Liao G, Nakayama T, Zhu B … Nayak JV, Jiang S. Multi-scaled transcriptomics of chronically inflamed nasal epithelium reveals immune-epithelial dynamics and tissue remodeling in nasal polyp formation. Immunity. 2025 Sep 12:S1074-7613(25)00372-3.
  6. Warner E, Liu ZW, Lechner M, Kotecha B. Attitudes to Local Anaesthesia in Radiofrequency Thermotherapy (RFTT) Sleep Surgery: Our Experience in a Single Centre with 42 Adult Patients. Clin Otolaryngol. 2018.
  7. Lechner M, Wilkins D, Kotecha B. A Review on Drug-Induced Sedation Endoscopy – Technique, Grading Systems and Controversies. Sleep Med Rev. 2018.
  8. Lechner M, et al. Snoring and Breathing Pauses During Sleep: Interview Survey of a United Kingdom Population Sample Reveals a Significant Increase in the Rates of Sleep Apnoea and Obesity Over the Last 20 Years – Data from the UK Sleep Survey. Sleep Med. 2018;54:250-256.
  9. Rehman U, Okhovat S, Woods R … Vyskocil E, Lechner M. The Development and Validation of Novel 3-Dimensional Models for Simulation Training in Sinonasal and Skull Base Surgery. Ann Otol Rhinol Laryngol. 2025.
  10. Rehman U, Colton D, Gupta S … Rollin M, Lechner M. Use of 3D-Printed Head and Neck Models for Simulating 10 Common ENT Emergency Procedures: A Prospective Validation Study. BMJ Open. 2025 May 11;15(5):e095877. 

Funding

Supported by Donors via the 

UCLH Charity