title: Paradoxical increase in nasal airway resistance after topical nasal decongestion - does it really exist? A retro- and prospective study.
abstract: OBJECTIVE
  To explore the prevalence and reproducibility of paradoxically increased nasal airway resistance after decongestion of the nasal mucosa as well as to identify patient-related factors associated with it.
  
  
  METHODS
  Retrospective analysis of all rhinomanometric measurements carried out at one ENT department in Sweden in the time between 1990 and 2010. In the baseline material, 207 of 4435 patients (4.7%) showed a paradoxically increased nasal airway resistance >20%. A follow-up rhinomanometry was performed in patients eligible for the study.
  
  
  METHODS
  Secondary care centre.
  
  
  METHODS
  Patients with paradoxically increased nasal airway resistance >20% who returned a complete questionnaire and had not undergone any nasal- or sinus surgery. Thirty-six patients (33-72 years) were eligible for the study.
  
  
  METHODS
  All patients answered a questionnaire and underwent rhinoscopy. Nasal airway resistance before and after decongestion with 0.1% xylometazoline hydrochloride was assessed by active anterior rhinomanometry.
  
  
  RESULTS
  Twelve of thirty-six patients (33%) showed a paradoxically increased nasal airway resistance in the follow-up rhinomanometry. No patient-related factors were identified.
  
  
  CONCLUSIONS
  The results indicate the existence and reproducibility of paradoxically increased nasal airway resistance.
authors.affiliation: ENT Department, Central Hospital Växjö, Växjö, Sweden.
authors.forename: S
authors.identifier: http://orcid.org/0000-0003-3717-9529
authors.initials: S
authors.lastname: Swoboda
authors.affiliation: ENT Department, Central Hospital Växjö, Växjö, Sweden.
authors.forename: H L
authors.initials: HL
authors.lastname: Thulesius
authors.affiliation: ENT Department, Central Hospital Växjö, Växjö, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Jessen
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000403:Airway Resistance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014663:Nasal Decongestants / Q000627:therapeutic use*; D009297:Nasal Mucosa / Q000503:physiopathology; D015508:Nasal Obstruction / Q000188:drug therapy* / Q000503:physiopathology*; D011446:Prospective Studies; D012189:Retrospective Studies; D025363:Rhinomanometry; D013548:Sweden
chemical_list: D014663:Nasal Decongestants