Symptomatic treatment of nasal congestion: improving the efficacy and safety of topical therapy

M.R. Bogomilsky ¹, E.Yu. Radtsig¹, N.D. Pivneva²

¹Pirogov Russian National Research Medical University, Moscow

²Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow

Background: nasal congestion is one of the most common complaints in pediatric practice. To reduce the severity of the adverse events (nose burning sensation, dry nasal mucosa, etc.) after the use of topical decongestants (TDs) in acute rhinitis, it is proposed to additionally use products with regenerating, protective and moisturizing effects.

Aim: to evaluate the treatment efficacy and tolerability during uncomplicated acute rhinosinusitis with a combination of xylometazoline and a complex preparation based on hyaluronic acid, vitamin E and lemon essential oil (Olyfrin).

Patients and Methods: a prospective single-center continuous non-randomized comparative study included patients aged 3 to 18 years with symptoms of acute infectious rhinitis, who were randomly divided into 2 groups. In group 1, patients received TDs: nasal spray with xylometazoline and a complex preparation based on hyaluronic acid, vitamin E and lemon essential oil (in the form of a nasal spray); in group 2 — only xylometazoline TD. The duration of TD use for therapeutic purposes was 7 days. Group 1 continued to use the complex preparation from day 8 to day 30. The following actions were performed in each of the groups: complaints evaluation, a routine ENT examination on the day of inclusion in the study, on the 7th and 30th day from the treatment initiation, including recording the results (evaluated on a 10-point VAS scale) in the patient’s chart.

Results: on the 7th day from the treatment initiation, patients of both groups noted an improvement in their condition. However, only in group 1, the dry nasal mucosa, nasal crusting, and especially bloody boogers in the nasal cavity were statistically significantl y (p<0.05) less (in terms of detection frequency and severity) than in the group 2. Recurrent episodes of rhinitis from the 7th to the 30th day of treatment in the group 1 were recorded in 14 (35%) patients, in group 2 — 37 (93%) (p<0,001).

Conclusions: the use of preparations with protective, regenerating and antioxidant effect on the nasal mucosa in the treatment of acute rhinitis can significantly reduce the adverse evetns after TDs use and shorten the recovery period of the epithelium and nasal mucosa after the inflammatory process.

Keywords: acute rhinitis, decongestants, xylometazoline hyaluronic acid, tocopherol, dry nasal mucosa, relapse.

For citation: Bogomilsky M.R., Radtsig E.Yu., Pivneva N.D. Symptomatic treatment of nasal congestion: improving the efficacy and safety of topical therapy. RMJ. 2022;2:31–35.