[Comparative study of the effect of vasoconstrictive and balsamic agents in the decongestant nasal test]

The authors report a study of 60 subjects with mono or bilateral nasal obstruction of different etiologies (30 vasomotor rhinopathy, 30 septum deviations) evaluating the decongestion action of a vasoconstrictor. This substance for topic use was administered in pill form both in association with and without different balsamic substances. The patients underwent subjective evaluation using a visual analogy scale (VAS) and an objective test such as active anterior rhinomanometry (AAR) and acustic rhinometry (AR). All evaluations were performed under basal conditions and after the nasal decongestion test (NDT). The results were processed in order to evaluate: a) relationships between the subjective results (VAS) and the objective instrumental tests (AAR and AR); b) the mechanism by which the balsamic substances affect the symptoms. The purpose was to evaluate exactly how important balsamic substances are in topic vasoconstrictor preparations. Finally, an attempt was made to confirm the importance of the nasal decongestion test to provide a concise diagnostic picture and a suitable medical or surgical approach to "nasal obstruction" symptoms. Among other things, the results underline the importance of objective methods; thanks to their reliability they now provide an essential support in the surgical indications and in following-up every nasal obstruction treatment, even as regards forensic medicine. From a strictly pharmacological point of view, whether associated with balsamic substances or not, vasoconstrictors give similar results with all evaluation methods. On the other hand, the balsamic action is limited to a subjective sensation of increased nasal air flow stemming from the stimulation of cutaneous thermoreceptors in the vestibule. Although this sensation does not correspond to an objective reduction in nasal resistance, it cannot be neglected in the treatment of obstructive symptoms where the psychological component can play an important role.