Effects of oxymetazoline on nasal flow and maximum aerobic exercise performance in patients with inferior turbinate hypertrophy

Abstract

1b.

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

“…found that the decongestant response was stronger for intranasal xylometazoline after 15 min than daily administration of intranasal mometasone furoate after 28 days. It is worth noting that only three studies included patients with AR, 1975–1977 the remainder consisted of healthy participants 1971–1974 …”

“…Onset of action is within 10 min, 1973 and duration of the effect lasts up to 12 h 1977 . There are also improvements in objective measures of nasal congestion/blockage, including nasal airway resistance, measures of nasal cavity volume for airflow, and PNIF 1972–1976 . Measures of nasal cavity volume for airflow exhibit a clear dose–response relationship across doses ranging from 6.25 to 50 μg, with nasal airway resistance requiring a higher threshold dose of 25 μg before significant changes in nasal patency are seen 1974 .…”

“…Despite oxymetazoline's vasoconstrictive effects, it does not seem to affect histamine‐induced plasma exudation 1971 . The majority of studies compared INDC to placebo, 1971–1974,1976 but Barnes et al 1975 . found that the decongestant response was stronger for intranasal xylometazoline after 15 min than daily administration of intranasal mometasone furoate after 28 days.…”

The inferior turbinate: An autonomic organ

“…Oxymetazoline, commonly marketed under the brand name Afrin, is a full α1 receptor agonist and a partial α2 receptor agonist. When oxymetazoline binds the alpha receptors found on the inferior turbinate vasculature, vasoconstriction occurs, the turbinate decongests, and nasal resistance decreases (Gómez-Hervás et al 2015). Oxymetazoline has been shown to be arguably the strongest decongestant, achieving the most rapid onset, longest duration of action, and greatest improvement in airway patency when compared with pseudoephedrine, the next strongest decongestant (Connell and Linzmayer 1987).…”

Nasal function and dysfunction in exercise

“…Despite these changes, the nasal airway contributes as little as 10 per cent of the overall minute ventilation at maximal exercise intensity 4 . The relative unimportance of the nasal airway can be demonstrated by the disappointing results of attempts to increase aerobic capacity by reducing nasal resistance through the use of ‘nasal dilator strips’ 5 – 7 or a pharmacological decongestant 8 . Equally, there is no hindrance to maximal aerobic performance when wearing an occlusive nose clip 9 .…”