Comparative evaluation of nasal blood flow and airflow in the decongestant response to oxymetazoline

Background: Nasal blood flow (NBF) plays a crucial role in many physiological and pathological processes but its regulation and relation to other rhinological outcomes is poorly understood.

Objectives: We measured nasal airway patency, nasal blood flow, and subjective and objective measures of decongestion and assessed their reproducibility and responsiveness.

Methods: 19 healthy adults attended twice. A dose-response curve was constructed using doubling doses of oxymetazoline of 25 mu g, 50 mu g, 100 mu g, and 200 mu g at 20 minute intervals. Peak nasal inspiratory flow (PNIF) and nasal airway resistance (NAR) were measured at baseline and after each successive dose, NBF using laser Doppler flowmetry at baseline, 50 mu g and 200 mu g and a decongestion visual analogue scale after the final dose.

Results: After the final dose of oxymetazoline, NBF decreased by a mean (95% CI, P value) of 139.6 (108.3-170.8, P < .001) units and 99.4 (68.1-130.7, P < .001) units, PNIF increased by 48.9 (22.0-75.8, P < .001) L.min-1 and 38.9 (12.0-65.8, P = .003) L.min-1, and NAR decreased by 0.1 (0.02-0.15, P < .001) Pa/s/cm(3) and 0.09 (0.02-0.15, P = .002) Pa.s.cm-3 at the first and second visits respectively. The area under the curve of decongestion was not significantly different between visits for each variable. The standardized response means for the decongestant response were as follows: NBF, 1.41; PNIF, 1.03; and NAR, 0.97.

Conclusions: Nasal blood flow using laser Doppler flowmetry is a sensitive and reproducible outcome to decongestion with oxymetazoline, similar to nasal patency and symptoms. Clinical Trials Registration: www.clinicaltrials.gov (NCT 00487032). (C) 2012 Published by Elsevier Inc. on behalf of American Society for Histocompatibility and Immunogenetics.