دورية أكاديمية
How Does Oxymetazoline Change Nasal Aerodynamics and Symptomatology in Patients with Turbinate Hypertrophy?
| العنوان: | How Does Oxymetazoline Change Nasal Aerodynamics and Symptomatology in Patients with Turbinate Hypertrophy? |
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| المؤلفون: | 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. |
| المصدر: | The Laryngoscope [Laryngoscope] 2024 Mar; Vol. 134 (3), pp. 1100-1106. Date of Electronic Publication: 2023 Aug 17. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 8607378 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-4995 (Electronic) Linking ISSN: 0023852X NLM ISO Abbreviation: Laryngoscope Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell Original Publication: St. Louis, Mo. : [s.n., 1896- |
| مواضيع طبية MeSH: | Nasal Obstruction*/drug therapy , Nasal Obstruction*/etiology , Paranasal Sinus Diseases*/drug therapy, Humans ; Oxymetazoline ; Turbinates/diagnostic imaging ; Prospective Studies ; Cohort Studies ; Hypertrophy |
| مستخلص: | 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. (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.) |
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| معلومات مُعتمدة: | n/a Bayer HealthCare |
| فهرسة مساهمة: | Keywords: adrenoceptor agonist; computational fluid dynamics modeling; oxymetazoline; turbinate hypertrophy; turbinate reduction; α1 and α2-adrenogeneic |
| المشرفين على المادة: | 8VLN5B44ZY (Oxymetazoline) |
| تواريخ الأحداث: | Date Created: 20230817 Date Completed: 20240219 Latest Revision: 20240219 |
| رمز التحديث: | 20240219 |
| DOI: | 10.1002/lary.30968 |
| PMID: | 37589314 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1531-4995 |
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| DOI: | 10.1002/lary.30968 |