title: Nasal decongestants in the treatment of chronic nasal obstruction: efficacy and safety of use.
abstract: Nasal decongestants are the most powerful drugs in the reduction of nasal obstruction. Despite their large use, local and systemic adverse reactions are frequent. The authors focus on the pharmacology of these kinds of drugs in light of the most recent knowledge on nasal pathophysiology. The ultrastructural anatomy of nasal mucosa explains the complexity of the possible interactions between the sympathomimetics and imidazoles derivates, and the submucosal layer. Nasal obstruction is one of the most frequent clinical problems that otorhinolaryngologists encounter daily, both in adults and children. All possible predisposing conditions to nasal obstruction are documented along with the better ways to diagnose them through nasal functionality tests. Active anterior rhinomanometry, acoustic rhinometry and the determination of mucociliary transport time represent, together with nasal endoscopy, the gold standard for an accurate diagnosis and the follow-up of the patient to cure. An updated review of the most significant works in this field and the best treatment protocol to avoid adverse effects, such as rhinitis medicamentosa, are reported.
authors.affiliation: Chief Professor, ENT Clinic University of Siena Medical School, Policlinico Le Scotte viale Bracci, 53100 Siena, Italy. passali@unisi.it
authors.forename: Desiderio
authors.initials: D
authors.lastname: Passàli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Salerni
authors.forename: Giulio Cesare
authors.initials: GC
authors.lastname: Passàli
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Passàli
authors.forename: Luisa
authors.initials: L
authors.lastname: Bellussi
mesh_terms: D002908:Chronic Disease; D006801:Humans; D014663:Nasal Decongestants / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015508:Nasal Obstruction / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D014663:Nasal Decongestants