1999 Volume 38 Issue 2 Pages 223-229
In this prospective study, we investigated changes to nasal airway patency in the immediate response to the topical nasal decongestant, tramazoline hydrochloride, in patients with various nasal diseases. The study was carried out on the following groups: the control group (n=15), the nasal allergy group against house dust mite (n=30), the chronic sinusitis group (n=25), and the laser cauterization group (n=12). The chronic sinusitis group was further subdivided into two groups whether visible nasal polyps existed in the nasal cavity. We employed acoustic rhinometry as an objective method, and the nasal cavity volume (NCV) and the minimum cross-sectional area (MCA) were calculated before and 10 minutes after nasal sprays.
In untreated condition, the average NCV in the severe nasal allergy group was 6.63cm3, which was significantly lower than that in the control group (7.8cm3). Further analysis indicated that the reduced NCV in this group was mainly due to obstructive changes to the first 3cm area of the nasal cavity. No significant difference in the untreated NCV was observed in the other groups.
Pharmacologic decongestion caused increased nasal patency by 56% from the baseline NCV values in the control group, 42% in the nasal allergy group, 26% in the sinusitis without nasal polyps group, 30% in the sinusitis with nasal polyps group, and 10% in the laser group. The reduction in responsiveness was statistically significant in the sinusitis groups (p<0.05) and in the laser group (p<0.01). Changes to the MCA also showed close correlation with those to the NCV detected in each group. On the other hand, the degree of changes to the cross-sectional area around the nasal valve region remained within 10% in all groups. The results presented in this study demonstrate that acoustic rhinometry is a valuable method for the objective assessment of nasal patency. The pharmacological effect of tramazoline seems to depend on the anatomical features of the nasal cavity, aging, and the pathological changes to the nasal mucosa as well as therapeutic effects against nose diseases.
