Physiologic and Clinical Estimates of the Relief of Nasal Flow Obstruction in Allergic Rhinitis: Effects of a Topical Decongestant (Oxymetazoline)

Abstract

Precise, sensitive electronic techniques offer the prospect of quantitating nasal pressure-flow relationships in disease and the impact of medical and surgical treatment. This study considered the value of electronic posterior rhinometry, and its correlation with qualitative clinical recording of patient status, arterial blood pressure, pulse and respiration rates, in the treatment of 30 children with chronic allergic rhinitis who received oxymetazoline pediatric nasal solution three times daily for two weeks. Computer analysis plotted inspiratory, expiratory and total nasal flow resistance curves for all patients and for children above and below 6 years of age. Use of the decongestant solution was marked by a fall from the elevated control means for the resistance measurements which was significant at the 95% confidence level and persisted for 14 days after treatment had been stopped. Measurements of vital signs did not differ meaningfully from baseline determinations. The behavior of the indices for the two age groups could not be differentiated statistically. Although correlation between observer ranking of responses and nasal ventilatory changes was of a low order of statistical significance, the trends were in good general agreement. The limitations and contributions of the independent laboratory and clinical judgments of the efficacy of drugs for allergic rhinitis are summarized as a preface to more definitive future trials.