Chest
Volume 114, Issue 1, July 1998, Pages 166-170
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Clinical Investigations
Effects of Different Mechanical Treatments on Nasal Resistance Assessed by Rhinometry

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The goal of this study was to compare the effectiveness of three treatments aiming to reduce nasal airflow resistance (NR): an external nasal strip device (Respir+), an internal nasal mechanical dilator (Nozovent), and a topical decongestant (Pernazène). NR was estimated by active posterior rhinometry at both a 0.5 L/s flow (NRF) and a 1 cm H2O pressure (NRp), under four conditions: in the basal state, with Respir+, with Nozovent, and after treatment with Pernazène. The efficacy of each treatment was assessed by the percentage changes in NRF and NRP (%NRF and %NRP, respectively). The study was performed in 15 healthy subjects. The efficacy of the treatments was significantly different, depending on whether it was evaluated by NRF or by NRP (p<0.02), with %NRF and %NRP values, respectively, equal to the following: 88±20% and 91±14% with Respir+, 58±17% and 70±13% with Nozovent, and 55±29% and 69±22% with Pernazène. NRF remained unchanged with Respir+, whereas it significantly decreased with Nozovent and Pernazène (p<0.0001). No significant difference was observed between the effects of the two latter treatments. These results demonstrate that Nozovent, which involves no risk of side effects or drug interactions, is an effective treatment to improve nasal breathing. Nozovent might therefore be recommended as an alternative to topical decongestants, for certain subjects presenting with nasal obstruction.

Section snippets

NR Measurement

NR was measured by active posterior rhinometry. The subjects breathed quietly through a rigid nasal mask, with the mouth occluded by a closed mouthpiece in which a 3-mm internal diameter catheter was inserted to measure pharyngeal pressure. Transnasal pressure (PTN) was measured by a differential pressure transducer (Sensym SCX 01D; Sunnival, Calif), one port of which was connected to the nasal mask and the other to the catheter. Nasal flow (V) was sensed by a screen pneumotachograph (Jaeger

Results

The K1 and K2 values obtained in the basal state are given in Table 1. In the basal state, no significant difference was observed between NRF and NRp (Table 1), and a highly significant correlation was found between these two estimates of NR (NRF = 1.43 NRp–0.83, r=0.99, p<0.0001).

As illustrated in Table 1, no significant change in K1 and K2 was observed with Respir+, whereas significant and comparable decreases in and K2 were observed with Nozovent and Pernazène (Table 1). The efficacy of the

Discussion

The efficacy of topical decongestants in reducing NR has been widely reported. By contrast, the objective efficacy of the mechanical treatments recently designed to open the nasal passages remains poorly documented,2, 3, 4 whereas the use of such treatments is becoming widespread, probably due to subjective criteria. This study was therefore initiated to quantify the respective effects on nasal resistance of two drug-free devices, namely an external nasal dilator (Respir+) and an internal nasal

Acknowledgments

The authors gratefully acknowledge Dr. Alain Harf for helpful reviewing of the manuscript.

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