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.