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How Does Oxymetazoline Change Nasal Aerodynamics and Symptomatology in Patients with Turbinate Hypertrophy?
Root, Zachary T; Lepley, Thomas J; Wu, Zhenxing; Chapman, Robbie J; Schneller, Aspen R; Formanek, Veronica L; Kelly, Kathleen M; Otto, Bradley A; Zhao, Kai.
Afiliación
  • Root ZT; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Lepley TJ; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Wu Z; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Chapman RJ; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Schneller AR; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Formanek VL; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Kelly KM; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Otto BA; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
  • Zhao K; Department of Otolaryngology - Head & Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
Laryngoscope ; 134(3): 1100-1106, 2024 Mar.
Article en En | MEDLINE | ID: mdl-37589314
OBJECTIVES: Oxymetazoline relieves nasal obstructive symptoms via vasoconstriction, however, the changes in nasal structures and aerodynamics that impact symptoms the most remain unclear. METHODS: This prospective, longitudinal, and single blinded cohort study applied Computational Fluid Dynamic (CFD) modeling based on CT scans at baseline and post-oxymetazoline on 13 consecutive patients with chronic nasal obstruction secondary to inferior turbinate hypertrophy from a tertiary medical center. To account for placebo effect, a sham saline spray was administered with subject blindfolded prior to oxymetazoline, with 30 min rest in between. Nasal Obstruction Symptom Evaluation (NOSE) and unilateral Visual Analogue Scale (VAS) scores of nasal obstructions were collected at baseline, after sham, and 30 min after oxymetazoline. RESULTS: Both VAS and NOSE scores significantly improved from baseline to post-oxymetazoline (NOSE: 62.3 ± 12.4 to 31.5 ± 22.5, p < 0.01; VAS: 5.27 ± 2.63 to 3.85 ± 2.59, p < 0.05), but not significantly from baseline to post-sham. The anatomical effects of oxymetazoline were observed broadly throughout the entire length of the inferior and middle turbinates (p < 0.05). Among many variables that changed significantly post-oxymetazoline, only decreased nasal resistance (spearman r = 0.4, p < 0.05), increased regional flow rates (r = -0.3 to -0.5, p < 0.05) and mucosal cooling heat flux (r = -0.42, p < 0.01) in the inferior but not middle turbinate regions, and nasal valve Wall Shear Stress (WSS r = -0.43, p < 0.05) strongly correlated with symptom improvement. CONCLUSION: Oxymetazoline broadly affects the inferior and middle turbinates, however, symptomatic improvement appears to be driven more by global nasal resistance and regional increases in airflow rate, mucosal cooling, and WSS, especially near the head of the inferior turbinate. LEVEL OF EVIDENCE: 3: Well-designed, prospective, single blinded cohort trial. Laryngoscope, 134:1100-1106, 2024.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de los Senos Paranasales / Obstrucción Nasal Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de los Senos Paranasales / Obstrucción Nasal Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos