PHYSIOLOGICAL VERSUS PHARMACOLOGICAL DECONGESTION OF THE NOSE IN HEALTHY-HUMAN SUBJECTS

In the present study we were interested to determine whether the maxim um unilateral nasal airflow associated with the nasal cycle (F-max phy siol) was equivalent to the maximum unilateral nasal airflow that coul d be achieved by the application of a topical nasal decongestant (F-ma x pharmacol). Eight healthy subjects (three male and five female, aged between 19-28 years) were recruited for this study. Unilateral nasal airflow was measured using posterior rhinomanometry at the inspiratory reference pressure of 75 Pa by alternately occluding each nostril wit h surgical tape. The study was run over 2 consecutive days. On day one , measurements of unilateral nasal airflow were performed every hour f or 8 h in each subject and F-max physiol was found to be 265 cm(3)/sec (147) (median and interquartile range). On day 2 the median unilatera l nasal airflow before application of the nasal decongestant was 171 c m(3)/sec (140) and this increased to 251 cm(3)/sec (127) (p = 0.046) a t 15 min and to 278 cm(3)/sec (134) (p = 0.005) at 45 min after applic ation of the decongestant (F-max pharmacol). A paired comparison of F- max physiol physiol and F-max pharmacol showed that these nasal airflo w measurements were not significantly different (p > 0.999). The resul ts show that there was no difference between the maximum physiological decongestion produced during the course of the nasal cycle and that p roduced pharmacologically by a topical nasal decongestant. This indica tes that the point of maximal sympathetic vasoconstrictor tone occurri ng during the nasal cycle causes a constriction of the nasal venous si nuses that is equal to the constrictor response that can be achieved b y applying a topical sympathomimetic medication.