5.2.1. Nasal dilators
Nasal dilators can be either fixed on the nasal dorsum or introduced in the nostrils, in order to open up the nasal valve region and reduce airflow resistance at this highly resistant area. These dilators are an elegant, non-surgical solution for alar insufficiency, leading to an important increase of nasal flow and good patient satisfaction77. Dinardi recently reviewed the effects of external nasal dilators on physical exercise 78 and one ohter study looked at an internal dilator 79. Although most of the studies fail to demonstrate an effect on total VO2max, heart rate or total exercise time78, nasal dilators significantly improved subjective exertion rates 80 and nasal breathing81 during exercise. It needs to be noted that most of these studies were performed in asymptomatic athletes. Only one study found similar results in adolescents with AR using an external nasal dilator 82, but none of these studies reported on nasal structural or rhinoscopic findings in the subjects.