Effects of Mucosal Decongestion on Nasal Aerodynamics: A Pilot Study
Ahmad T. Hamdan, Giancarlo B. Cherobin, Richard L. Voegels, John S. Rhee, Guilherme J. M. Garcia- Otorhinolaryngology
- Surgery
Abstract
Objective
Mucosal decongestion with nasal sprays is a common treatment for nasal airway obstruction. However, the impact of mucosal decongestion on nasal aerodynamics and the physiological mechanism of nasal airflow sensation are incompletely understood. The objective of this study is to compare nasal airflow patterns in nasal airway obstruction (NAO) patients with and without mucosal decongestion and nondecongested healthy subjects.
Study Design
Cross‐sectional study of a convenience sample.
Setting
Academic tertiary medical center.
Methods
Forty‐five subjects were studied (15 nondecongested healthy subjects, 15 nondecongested NAO patients, and 15 decongested NAO patients). Three‐dimensional models of the nasal anatomy were created from computed tomography scans. Steady‐state simulations of airflow and heat transfer were conducted at 15 L/min inhalation rate using computational fluid dynamics.
Results
In the narrow side of the nose, unilateral nasal resistance was similar in decongested NAO patients and nondecongested healthy subjects, but substantially higher in nondecongested NAO patients. The vertical airflow distribution within the nasal cavity (inferior vs middle vs superior) was also similar in decongested NAO patients and nondecongested healthy subjects, but nondecongested NAO patients had substantially less middle airflow. Mucosal cooling, quantified by the surface area where heat flux exceeds 50 W/m2, was significantly higher in decongested NAO patients than in nondecongested NAO patients.
Conclusion
This pilot study suggests that mucosal decongestion improves objective measures of nasal airflow, which is consistent with improved subjective sensation of nasal patency after decongestion.