Effects of the nasal strip and dilator on nasal breathing--a study with healthy subjects.

OBJECTIVE: To investigate effects of the nose dilating devices on nasal anatomy and breathing in healthy subjects. MATERIALS AND METHODS: 27 healthy subjects were tested when using the Breathe Right nasal strip or the Nozovent dilator. Posterior rhinomanometry, acoustic rhinometry, and a subjective evaluation were used as methods. RESULTS: Both devices significantly increased the minimum cross-sectional area of the nasal valve and decreased nasal resistance. The Nozovent dilator proved to be significantly more effective in reducing nasal resistance than the Breathe Right nasal strip. CONCLUSIONS: Nose dilating devices, the Breathe Right nasal strip and the Nozovent dilator, can be used to reduce nasal resistance. More studies are needed to evaluate the usefulness of the devices for patients with chronic obstruction for any reason in the valve area.

Peak nasal inspiratory and expiratory flow measurements--practical tools in primary care?

General practitioners diagnose and treat numerous patients with nasal problems but have no objective equipment to aid diagnosis. We studied the characteristics of peak nasal inspiratory (PNIF) and expiratory (PNEF) flows to explore their utility for primary care use. One hundred healthy volunteers, 50 men, 50 women, performed PNIF and PNEF measurements in standardised laboratory circumstances. Repeatability was tested for a subgroup of 20 women who performed two consecutive series of PNIF and PNEF at a 2-minute interval. Diurnal variability was tested with a subgroup of 10 men and 10 women who recorded PNIF and PNEF values at home every morning and evening for 7 days. Distribution of individual values for both PNIF and PNEF was wide and independent of subject's age, height, or gender. Repeatability was poor and diurnal variation substantial. PNIF and PNEF lack the properties of good clinical tests and thus cannot be recommended for primary care use.

Early treatment of perennial rhinitis with budesonide or cetirizine and its effect on long-term outcome.

BACKGROUND: Perennial rhinitis is a common disease that has many similarities with bronchial asthma. Early treatment with inhaled steroids has improved asthma symptoms, lung function, and bronchial hyperreactivity, but it has not been studied in perennial rhinitis. OBJECTIVE: The main objective was to determine whether early introduction of long-term daily intranasal steroid treatment would have a positive effect on the clinical course and outcome of perennial rhinitis compared with the effect of an antihistamine. A secondary objective was to compare the clinical efficacy of intranasal budesonide and oral cetirizine. METHODS: One hundred forty-three adult patients with newly detected perennial allergic or nonallergic eosinophilic rhinitis of 1 to 3 years' duration were randomized to receive budesonide dry powder, 400 microg (delivered dose of 280 microg) intranasally, or cetirizine, 10 mg orally, once daily for 1 year. At the end of the double-blind treatment period, medication was stopped, and the patients were followed for another year, during which time they could use 14-day courses of intranasal budesonide as needed to control rhinitis relapses. The main outcome measures were the time to first relapse and the number of relapses during the second year. Nasal symptom scores, nasal smear eosinophilia, and nasal peak expiratory flow were used to compare the clinical efficacy of the 2 treatments. RESULTS: During the randomized phase of the study, budesonide was significantly more effective than cetirizine in relieving nasal symptoms. Nasal peak expiratory flow improved significantly in budesonide-treated patients compared with in patients receiving cetirizine. After discontinuation of randomized treatment, 38% of budesonide-treated and 56% of cetirizine-treated patients had a relapse within the first month (P =.04). The median time to first relapse was longer in budesonide-treated patients than in cetirizine-treated patients (62 vs 20 days), although the difference was not significant. Fourteen-day courses of budesonide provided effective control of relapses; the mean number of relapses was 4.0 versus 5.4 in the groups previously treated with budesonide or cetirizine, respectively. Both treatments were well tolerated throughout the study. CONCLUSIONS: Budesonide is significantly more effective than cetirizine in controlling perennial rhinitis. After stopping treatment, budesonide better prevents relapses for 1 to 2 months compared with cetirizine. Periodic therapy with budesonide may be sufficient to control symptoms in most patients who have relapses.