CORRELATION BETWEEN OBJECTIVE NASAL MUCOSAL SWELLING AND ESTIMATED STUFFINESS DURING LONG-TERM USE OF VASOCONSTRICTORS

The correlation between nasal mucosal swelling and estimated stuffines s was evaluated in 13 healthy volunteers who entered the trial. The na sal mucosa was challenged with increasing concentrations of histamine solutions. The amount of mucosal swelling was recorded using rhinoster eometry, and the stuffiness was estimated by the subjects on a visual analogue scale. Then the subjects were randomly chosen to receive eith er oxy- or xylometazoline nasal spray for 30 days. After 10 days on th e drug, the histamine sensitivity was enhanced, and after another 20 d ays, it had increased further, reflecting the development of rhinitis medicamentosa. Before the subjects started the nasal spray and after 1 0 days on the drug, a correlation between stuffiness and swelling was seen in the individual subject only when the degree of stuffiness almo st obliterated the nasal opening. At the end of the month, no correlat ion was present. In all histamine provocations throughout the month, a very high correlation was noted between mean mucosal swelling and mea n stuffiness. It is concluded that the symptom scores for nasal obstru ction are useful for determining nasal mucosal swelling in groups. How ever, in the individual subjects one can estimate the mucosal swelling only when the amount of swelling almost obliterates the nasal opening . This cannot be done when the mucosa is hyperreactive.