Paradoxical sensation of nasal airflow in patients with common cold. Are we measuring the correct modality?

A paradoxical relationship between objective and subjective measures of nasal obstruction exists in participants not exposed to any treatment. The sensation of nasal obstruction may be due to the amalgamation of many different nasal sensations. Improved methods for measuring nasal sensations are required to further investigate the relationship between objective and subjective measures of nasal obstruction.

In a recent study it was shown that the subjective sensation of nasal patency increased as the nasal passages became objectively more obstructed in patients who received a placebo compared to those who received an oral decongestant. This paradoxical response may be explained as a placebo effect, i.e. patients who received a placebo may have expected to feel less obstructed. The aim of the present study was to investigate this interesting paradox by determining objective and subjective measures of nasal obstruction over time in participants not exposed to any treatment.

A total of 60 healthy participants with common cold were recruited. Objective and subjective measures of nasal obstruction were recorded at baseline and at 1 and 2 h using posterior rhinomanometry and a visual analogue scale.

Objective measures demonstrated an increase in nasal obstruction over time for both nasal passages considered together and for individual nasal passages. Subjective measures demonstrated a sensation of decreased nasal obstruction over time for both nasal passages considered together and for individual nasal passages.