Physiology and pharmacology of nasal function and mucus secretion

The nose plays an important part in the normal physiological function of the body and is a key defense against airborne noxious influences. The ability of the nose to play these roles is dependent upon a normal nasal airway and healthy nasal mucosa. Most nasal diseases run a self-limited course, and injury resulting therefrom is quickly followed by a restoration of normal function. In the treatment of nasal symptoms the physician must carefully weigh the desire to alleviate the patient's discomfort against the possibility of acutely or chronically impairing nasal function.

Even a cursory examination of the literature reveals the paucity of reliable information not only on the relative effectiveness of most pharmacological agents employed in nasal disease, but also on their adverse effects upon nasal function. We now have a better understanding of nasal function which can serve as a guide to those seeking the discovery of improved nasal medications. We also have readily available tools for measuring some of the desired effects of drugs upon nasal function and some of the functions which might be injured. Rhinomanometry (Brown, 1967; Bridger and Proctor, 1970) and measurement of mucociliary function (Hill, 1957; Gosselin, 1961; Quinlan et al., 1969; Dadaian, 1971; Sakakura et al., 1973) can be carried out by intelligent investigators in most first class clinical environments. Climate chambers are available for testing the effects of environmental influences and for measuring the effect of therapeutic agents under controlled conditions (Proctor et al., 1973a). We urge that appropriate studies be employed for weighing the relative usefulness of currently used drugs and for testing new ones prior to their release for public consumption. Clinical impression, upon which we must now to a large degree rely, should not be accepted in the future as adequate evidence supporting pharmacological therapy of nasal disease.