gms | German Medical Science

Introduction: Congestion is a leading symptom of an allergic nasal reaction. While this is mainly due to the cavernous tissue of the inferior turbinate, other structures like the nasal septum are also involved in the allergic response. However, the vascular structure of the nasal septum and the inferior turbinate are different. In the inferior turbinate swelling bodies can be found, whereas the nasal septum (Kiesselbach’s area) is characterised by a dense arterial mesh. The aim of this study was to investigate whether the two areas exhibit different swelling mechanisms in allergic nasal reactions.

Methods: Two optical rhinometers were used. Optical rhinometry is based on the transillumination of the nasal septum/the inferior turbinate or the whole nose with monochromatic light. Its wavelength can be adjusted to the absorption characteristics of reduced hemoglobin, oxygen saturated haemoglobin, and water. Optic rhinometry was performed in 11 subjects during the course of nasal histamine administration.

Results: Following administration of histamine, in the nasal septum the wavelength of 950 nm (edema) showed the strongest increase of extinction. In the inferior turbinate it was the wavelength of 786 nm (oxygenated hemoglobin). In the whole nose the wavelength of 880 nm (edema plus hemoglobin) exhibited the largest increase of extinction.

Conclusion: Swelling of the nasal septum (Kiesselbach’s area) in nasal allergic reactions is mainly caused by edema, whereas swelling of the inferior turbinate is mainly due to an increase in blood volume, which is highly saturated with oxygen. Swelling of the whole nose is characterized by the combination of both, edema and increase in blood volume.