EFFECT OF CORTICOSTEROIDS ON NASAL BLOCKAGE IN RHINITIS MEASURED BY OBJECTIVE METHODS

This paper gives an overview of placebo-controlled studies of the effe ct of corticosteroid treatment on nasal blockage, based on objective m easurements of nasal airway patency. A few studies of perennial rhinit is have indicated that pretreatment with an intranasal corticosteroid has a moderate effect on nasal hyperresponsiveness, measured as the hi stamine-induced increase of nasal blockage. Whereas the effect on alle rgen-induced early-phase symptoms is variable, the effect on the late- phase blockage is almost complete. In seasonal allergic rhinitis, a fe w studies have shown an effect of intranasal steroids on nasal airway resistance, nasal peak flow and on acoustic rhinometry, but there are no reports on the effect in adults with perennial rhinitis. In childre n with perennial disease, intranasal treatment results in increased na sal patency and, in one study, also in reduced mouth breathing and in an increased threshold for exercise-induced bronchoconstriction. In pa tients with nasal polyposis, intranasal steroids have an effect on nas al airway resistance and on nasal peak flow both before and after poly pectomy. There is convincing evidence that intranasal corticosteroids provide a better effect than antihistamine on nasal blockage. Amazingl y, there does not appear to be any report on the effect of systemic co rticosteroid treatment on nasal airway patency, and it is therefore di fficult to recommend this treatment in a rational dosage. In conclusio n, there is a fairly good documentation in support of the efficacy of intranasal steroid treatment on nasal airway patency in rhinitis. An o bjective measurement of nasal airway patency ought to be the routine i n controlled rhinitis trials.