書誌事項
- タイトル別名
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- Nasal decongestion evaluated by acoustic rhinometry.
- acoustic rhinometryを用いて
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抄録
Acoustic rhinometry measures the cross-sectional area of the nasal cavity based on changes in acoustic impedance. The volume of the nasal cavity can be calculated by mathematical integra-tion of the cross-sectional areas. One of the advantages of this procedure is that repeated measurements can be quickly performed non-invasively. In this study, we analyzed the mecha-nisms of nasal mucosal decongestion after applying vasoactive agents.<br>The experiments were performed in normal adult volunteers (17 males, 3 females) who gave their informed consent to participate in this study. Three vasoactive agents (0.1% epinephrine, 0.5% phenylephrine hydrochloride, 0.5% oxymetazoline hydrochloride), two alpha-receptor antag-onists (0.2phenoxybenzamine, 0.4% yohimbine) and a local anesthetic (4% lidocaine) wereused. In order to apply the agents precisely and safely, we attached a 6mmdiameter discmoistened with 0.1ml of solution to the anterior portion of the inferior turbinate unilaterally for fifty seconds. After removing thedisc, acoustic measurements were performed for an hour. To analyze data we divided the nasal cavity into three portions, i. e., anterior, middle and posterior.<br>Volume changes in each portion are expressed as percentages.Immediately after applying phenylephrine and oxymetazoline, ipsilateral volume in the anteriorportion began to increase, and then extended posteriorly. The level of decongestion remained unchanged for an hour. Contralateral volume decreasedin allportions. When epinephrine was applied, mucosal decongestion occurred first followed by congestion in all portions of the ipsilateral side after 20 minutes. Mucosal congestion occurred in all portions of the contralateral side.<br>After applying phenoxybenzamine or yohimbine for ten minutes, we administered vasoactive agents topically. Pretreatment with alpha-1 antagonist almost totally suppressed the mucosal decongestion caused by phenylephrine and oxymetazoline. Contralateral congestion was decreased by antagonizing the suppression of ipsilateral decongestion. After application of lidocaine for ten minutes, phenylephrine still caused ipsilateral decongestion only in the anterior portion, but decongestion of the middle and posterior portion and congestion on the contralateral side totally disappeared.<br>These findings suggest the following conclusions: 1) decongestion evoked by adrenergic agents is probably caused by direct activation of alpha-1receptors, 2) decongestion of the middle and posterior portions is evoked by drug particles conveyed by ciliary movement, and 3) the contralateral responseisprobably related to the activation of sensory nerves on the ipsilateral side.
収録刊行物
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- 日本耳鼻咽喉科学会会報
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日本耳鼻咽喉科学会会報 97 (11), 2075-2084, 1994
一般社団法人 日本耳鼻咽喉科頭頸部外科学会