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Regional Patterns of Nasal Decongestion

Objective: We present a study investigating the effect of a decongestant on the nasal mucosa, showing results in terms of the change in erectile tissue volume (ETV) in normal subjects using high resolution 3T-MRI scanning. Method: Seven volunteers with no nasal complaints (SNOT-22) or obvious rhinoscopic abnormalities were studied. Each subject underwent 2 MRI scans producing a series of 120 contiguous 1.2 mm sections pre- and postdecongestion. Patients were decongested with xylometazoline-HCL, remaining immobilized following the first scan. The scans were segmented using ITK-Snap and analyzed using MATLAB. Results: Subject age ranged from 21-38 years (mean = 28). The SNOT-22 scores ranged from 1-10 (mean = 4.8). Decongestion had the greatest effect in 3 sites: the inferior turbinates, middle turbinates, and septum. The greatest change in ETV was observed in the inferior turbinates (P <.005), reducing by up to 1/3 at the posterior aspect of the inferior turbinate following decongestion. Changes were also seen in ETV of the middle turbinate and septal mucosa to a lesser extent. Conclusion: The effect of decongestion on ETV has been investigated here in far greater detail than previously studied, and at higher spatial resolution. 3T-MRI was found to be an excellent modality for mapping changes in nasal mucosa. Our results demonstrate the significant effect of decongestion on ETV of the inferior turbinates.