title: Oxymetazoline Applied Topically to the Nasal Mucosa Decreases Trans-Mucosal Nitrous Oxide Exchange for the Middle Ear.
abstract: OBJECTIVE
  Determine if the middle ear (ME) trans-mucosal nitrous oxide (N2O) gas exchange rate can be pharmacologically modulated by the nasal application of a vasoconstrictor.
  
  
  METHODS
  In a randomized, double-blind, crossover study, 20 adults received a nasal spray challenge containing either oxymetazoline or saline (placebo). At each session, subjects were fitted with a non-rebreathing mask and breathed room air for 20 minutes, 50% N2O:50% O2 for 20 minutes, and 100% O2 for 10 minutes. Throughout, heart rate, blood pressure (BP), and blood O2 saturation were monitored, and bilateral ME pressure was recorded by tympanometry every minute. The primary outcome measure was the slope of the ME pressure-time function for the experimental period, a direct measure of the transMEM N2O exchange constant. The effects of treatment, session, and period on the measured vital signs and of treatment, session, disease history, and ear on the ME pressure-time slopes were evaluated for statistical significance using repeated measures ANOVAs.
  
  
  RESULTS
  The analysis documented a significant effect of period on O2 saturation (N2O > room air, P = .03) and of treatment on blood pressure (oxymetazoline > placebo, P < .02) and the ME pressure-time slope (placebo > oxymetazoline, P = .05).
  
  
  CONCLUSIONS
  The exchange rate across the ME mucosa of inert gases can be decreased by topical treatment of the nasal mucosa with oxymetazoline.
authors.affiliation: Department of Otolaryngology, School of Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA teixeirams@upmc.edu.
authors.forename: Miriam S
authors.initials: MS
authors.lastname: Teixeira
authors.affiliation: Department of Otolaryngology, School of Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
authors.forename: Cuneyt M
authors.initials: CM
authors.lastname: Alper
authors.affiliation: Division of Pediatric Dentistry, School of Dental Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Dentistry, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Martin
authors.affiliation: Division of Pediatric Dentistry, School of Dental Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Dentistry, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
authors.forename: Narmin
authors.initials: N
authors.lastname: Helal
authors.affiliation: Department of Human Genetics, School of Public Health of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Brendan M Cullen
authors.initials: BM
authors.lastname: Doyle
authors.affiliation: Department of Otolaryngology, School of Medicine of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Doyle
mesh_terms: D000158:Acoustic Impedance Tests; D000281:Administration, Intranasal; D000287:Administration, Topical; D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004432:Ear, Middle / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D014663:Nasal Decongestants / Q000008:administration & dosage; D009297:Nasal Mucosa / Q000187:drug effects / Q000378:metabolism* / Q000473:pathology; D009609:Nitrous Oxide / Q000378:metabolism*; D010109:Oxymetazoline / Q000008:administration & dosage*; D011312:Pressure; D012016:Reference Values; D013997:Time Factors
chemical_list: D014663:Nasal Decongestants; D010109:Oxymetazoline; D009609:Nitrous Oxide
keywords: blood flow; middle ear mucosa; middle ear pressure; nitrous oxide; oxymetazoline; physiology