Nose drops are widely used in the topical treatment of nasal disorders. The
ir efficacy has previously been shown to depend on the position of the head
adopted during instillation. All three of the commonly recommended head po
sitions (head back, praying-to-Mecca, Mygind's) are uncomfortable, and this
may affect patient compliance. As yet, no assessment has been made of the
discomfort encountered by patients. Twenty adults from a general otolaryngo
logy clinic were asked to adopt each of three positions and then rate the d
iscomfort experienced on a 10 cm visual analogue scale. The results show th
at although Mygind's position is well tolerated, the praying-to-Mecca posit
ion was significantly more uncomfortable than any other. In the absence of
any evidence that the praying-to-Mecca position is clinically more efficaci
ous than Mygind's, it seems inappropriate to continue to advocate its use.