Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-06-01T10:10:10.777Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of topical xylometazoline on Eustachian tube function

Published online by Cambridge University Press:  22 January 2020

K S Joshi ,
V W Q Ho ,
M E Smith  and
J R Tysome
K S Joshi
Affiliation:
School of Clinical Medicine, University of Cambridge, UK
V W Q Ho
Affiliation:
School of Clinical Medicine, University of Cambridge, UK
M E Smith
Affiliation:
Cambridge Ear Institute, University of Cambridge, UK
J R Tysome*
Affiliation:
Cambridge Ear Institute, University of Cambridge, UK
*
Author for correspondence: Mr James R Tysome, Department of ENT Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, CambridgeCB2 0QQ, UK E-mail: james.tysome@addenbrookes.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Topical nasal decongestants are frequently used as part of the medical management of symptoms related to Eustachian tube dysfunction.

Objective

This study aimed to assess the effect of topical xylometazoline hydrochloride sprayed in the anterior part of the nose on Eustachian tube active and passive opening in healthy ears.

Methods

Active and passive Eustachian tube function was assessed in healthy subjects before and after intranasal administration of xylometazoline spray, using tympanometry, video otoscopy, sonotubometry, tubo-tympano-aerodynamic-graphy and tubomanometry.

Results

Resting middle-ear pressures were not significantly different following decongestant application. Eustachian tube opening rate was not significantly different following the intervention, as measured by all function tests used. Sonotubometry data showed a significant increase in the duration of Eustachian tube opening following decongestant application.

Conclusion

There remains little or no evidence that topical nasal decongestants improve Eustachian tube function. Sonotubometry findings do suggest that further investigation with an obstructive Eustachian tube dysfunction patient cohort is warranted.

Keywords

Eustachian TubeBarotraumaMiddle Ear VentilationNasal Sprays
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 1 , January 2020 , pp. 29 - 33
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr J R Tysome takes responsibility for the integrity of the content of the paper

Presented at the 32nd Politzer Society Meeting and 2nd World Congress of Otology, 28 May – 1 June 2019, Warsaw, Poland.

References

BMJ Best Practice: Eustachian tube dysfunction. In: https://newbp.bmj.com/topics/en-gb/1142 [29 December 2019]Google Scholar
Corboz, MR, Rivelli, MA, Mingo, GG, McLeod, RL, Varty, L, Jia, Y et al. Mechanism of decongestant activity of alpha 2-adrenoceptor agonists. Pulm Pharmacol Ther 2008;21:449–5410.1016/j.pupt.2007.06.007CrossRefGoogle ScholarPubMed
Hall, LJ, Jackson, RT. Effects of alpha and beta adrenergic agonists on nasal blood flow. Ann Otol Rhinol Laryngol 1968;77:1120–30Google ScholarPubMed
Proctor, DF, Adams, GK 3rd. Physiology and pharmacology of nasal function and mucus secretion. Pharmacol Ther B 1976;2:493–509Google ScholarPubMed
Westerveld, GJ, Scheeren, RA, Dekker, I, Griffioen, DH, Voss, HP, Bast, A. Anti-oxidant actions of oxymethazoline and xylomethazoline. Eur J Pharmacol 1995;291:27–31Google ScholarPubMed
Westerveld, GJ, Voss, HP, van der Hee, RM, de Haan-Koelewijn, GJ, den Hartog, GJ, Scheeren, RA et al. Inhibition of nitric oxide synthase by nasal decongestants. Eur Respir J 2000;16:437–44Google ScholarPubMed
Ovari, A, Buhr, A, Warkentin, M, Kundt, G, Ehrt, K, Pau, H-W. Can nasal decongestants improve eustachian tube function? Otol Neurotol 2015;36:65–9Google ScholarPubMed
Meyer, MF, Mikolajczak, S, Korthäuer, C, Jumah, MD, Hahn, M, Grosheva, M et al. Impact of xylomethazoline on eustachian tube function in healthy participants. Otol Neurotol 2015;36:769–75Google ScholarPubMed
Jensen, JH, Leth, N, Bonding, P. Topical application of decongestant in dysfunction of the Eustachian tube: a randomized, double-blind, placebo-controlled trial. Clin Otolaryngol Allied Sci 1990;15:197–20110.1111/j.1365-2273.1990.tb00775.xCrossRefGoogle ScholarPubMed
Barotrauma of the Ear. In: https://patient.info/ears-nose-throat-mouth/earache-ear-pain/barotrauma-of-the-ear [29 December 2019]Google Scholar
HealthCentral: Ear Discomfort and Airplane Travel. In: https://www.healthcentral.com/encyclopedia/ear-discomfort-and-airplane-travel [29 December 2019]Google Scholar
Smith, ME, Takwoingi, Y, Deeks, J, Alper, C, Bance, ML, Bhutta, MF et al. Eustachian tube dysfunction: a diagnostic accuracy study and proposed diagnostic pathway. PLoS One 2018;13:1–2810.1371/journal.pone.0206946CrossRefGoogle ScholarPubMed
Smith, ME, Zou, CC, Baker, C, Blythe, AJC, Hutchinson, PJA, Tysome, JR. The repeatability of tests of eustachian tube function in healthy ears. Laryngoscope 2017;127:2619–2610.1002/lary.26534CrossRefGoogle ScholarPubMed
Smith, M, Blythe, AJ, Baker, C, Zou, C, Hutchinson, PJ, Tysome, J. Tests of Eustachian tube function: the effect of testing technique on tube opening in healthy ears. Otol Neurotol 2017;38:714–2010.1097/MAO.0000000000001375CrossRefGoogle ScholarPubMed
Schröder, S, Lehmann, M, Korbmacher, D, Sauzet, O, Sudhoff, H, Ebmeyer, J. Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction. Clin Otolaryngol 2015;40:691–710.1111/coa.12451CrossRefGoogle ScholarPubMed
Svane-Knudsen, V, Kruse, S, Lildholdt, T, Madsen, T. Sympathetic influence on the normal Eustachian tube: an experimental study in the rat. Acta Otolaryngol 1986;101:263–8Google ScholarPubMed
van Heerbeek, N, Ingels, KJAO, Zielhuis, GA. No effect of a nasal decongestant on Eustachian tube function in children with ventilation tubes. Laryngoscope 2002;112:1115–1810.1097/00005537-200206000-00033CrossRefGoogle ScholarPubMed
Olen, L, Holmquist, J. The influence of nasal decongestants on Eustachian tube function [Abstract]. In: Lim, DJ, Bluestone, CD, Klein, JO, Nelson, JD, eds. Proceedings of the Fifth International Symposium on Recent Advances in Otitis Media. Toronto: BC Decker, 1993Google Scholar
Jones, JS, Sheffield, W, White, LJ, Bloom, MA. A double-blind comparison between oral pseudoephedrine and topical oxymetazoline in the prevention of barotrauma during air travel. Am J Emerg Med 1998;16:262–410.1016/S0735-6757(98)90097-3CrossRefGoogle ScholarPubMed