A study of the physiologic relationship of lower and upper airways with 133Xe

In order to test the hypothesis that there is air streaming through the upper airways to the ipsilateral lung, and that reflex hypoventilation of the ipsilateral lung may occur in unilateral nasal obstruction, 11 volunteers and three patients were examined for these phenomena, employing Xenon-133 (133Xe) and a special mask permitting inhalation of the gas through one nostril at a time. Patients with deviated nasal septa were also examined, one of these before and after surgery. There was no difference in 133Xe distribution between right and left lungs when gas was inhaled through either normal nostril as compared to inhalation through the mouth, in patients with deviated septa or with cotton obstruction of the contralateral nostril. Furthermore, there was no evidence of delayed washout of 133Xe from either lung or any segment thereof under conditions of nasal obstruction. Thus acute or chronic nasal obstruction does not alter the distribution of inpired gas to the lungs. Neither air streaming nor reflex bronchoconstriction occurs with nasal obstruction.