Oxymetazoline Can Shorten the Time Required for a Bronchoscope to Reach the Vocal Cords in Patients With Turbinate Hypertrophy

OBJECTIVES: This study aims to investigate the effects of oxymetazoline on the time required for the bronchoscope to reach the vocal cords, nasal manipulation difficulty during bronchoscopy, nasal mucosal injury, and patient-reported pain in individuals with turbinate hypertrophy undergoing bronchoscopic examination. MATERIALS AND METHODS: This prospective, double-blinded, randomised controlled trial enrolled 240 patients with turbinate hypertrophy (November 2023 to July 2024), randomised into oxymetazoline, saline, and blank control groups (n = 80 each). The primary outcome was bronchoscope-to-vocal-cords time. Secondary outcomes included operator-assessed nasal passage ease (negotiation visual analog scale [VAS]), assistant-evaluated facial pain (Facial Pain Scale), patient-reported nasal pain (Pain VAS), operator-rated mucosal trauma (Trauma VAS) and hemodynamic parameters. RESULTS: The oxymetazoline group demonstrated significantly shorter bronchoscope-to-vocal-cords time compared to the saline group (44.00 s [41.00-47.00] vs. 52.00 s [50.00-58.00], p < 0.001), improved nasal passage ease (negotiation VAS: 3.00 [2.00-4.00] vs. 5.00 [4.00-6.00], p < 0.001), and reduced mucosal trauma (Trauma VAS: 7.00 [6.00-8.00] vs. 9.00 [8.00-9.00], p < 0.001). Patients receiving oxymetazoline reported lower nasal pain scores (assistant-assessed: 4.00 [3.00-5.00] vs. 5.00 [5.00-6.00]; patient-reported: 4.00 [3.00-4.75] vs. 5.50 [5.00-6.00], both p < 0.001). CONCLUSION: Oxymetazoline optimises bronchoscopy in turbinate hypertrophy patients by shortening procedural time, easing nasal passage, mitigating mucosal injury, and alleviating pain. This trial is registered at chictr.org.cn (ChiCTR2300077642).