A Comparative Study Of The Cold Spatula Test And The Glatzel Mirror For Nasal Obstruction Screening In Indonesian Primary Healthcare Settings

Background: This study aimed to compare two simple tools, the metal spatula (cold spatula test) and the Glatzel mirror, in detecting nasal obstruction in a primary healthcare facility in Indonesia. The study provides a direct comparison between two non-invasive, low-cost screening tools whose effectiveness has not been widely evaluated in Indonesia. Methods: A cross-sectional study was conducted involving 34 healthy subjects aged 18–59 years. Each participant underwent nasal airflow assessment using both tools. Condensation patterns were visually assessed to evaluate symmetry and condensation area. Results: The Glatzel mirror yielded an average condensation area of 4.1 cm (SD 0.5), ranging from 3.1 to 5.1 cm, with a median left–right nostril difference of 0.2 cm. The maximum difference was 1.4 cm, below the clinical threshold of 2 cm for nasal obstruction. In contrast, the cold spatula test produced only qualitative results, with all participants categorized as having wide condensation. A Wilcoxon signed-rank test showed a statistically significant user preference for the Glatzel mirror (Z = –2.183, p = 0.029). Conclusion: The Glatzel mirror provided more objective and quantifiable results than the metal spatula and was more favorably rated by users. These findings support its potential as a practical and informative screening tool for nasal obstruction in resource limited primary care settings in Indonesia. Trial registration : Not applicable.