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Jose Miguel Chatkin, MD; Wei Qian, MD; Patricia A. McClean, MSc; Noe Zamel, MD; James Haight, MD; Phillip Silkoff, MD

Arch Otolaryngol Head Neck Surg. 1999;125:682-685.

Background  Nasal nitric oxide is present in high concentrations in the upper airway relative to the lower respiratory tract.

Objective  To explore the rate of nitric oxide accumulation in the nonventilated nasal cavity.

Methods  In 9 healthy subjects previously trained to close the soft palate, steady-state plateau nitric oxide levels were recorded while air was aspirated through the nasal airway in series at a constant flow rate. Nitric oxide was then allowed to accumulate in the nasal cavity by occluding both nares and keeping the velum closed. After varying occlusion times, peak nitric oxide levels and a second plateau were ascertained.

Results  While the subjects aspirated air at a constant flow, there was a slow rise to a first nitric oxide plateau. On opening to the analyzer after the accumulation period, the peak nitric oxide level was several times higher than the initial plateau (range, 2810-19,008 ppb) and then slowly returned to previous plateau levels. There was no significant difference between initial and second plateau nitric oxide levels for any period. The accumulated nitric oxide peak increased in direct proportion to the accumulation time (P<.001).

Conclusions  Nitric oxide concentrations accumulate in the nonventilated nasal cavity in proportion to the time of nonventilation. Peak nasal nitric oxide values after accumulation are similar to published sinus nitric oxide measurements obtained by direct puncture. These results suggest an important alternative source of nitric oxide in humans.

From the Catholic University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Chatkin); Zhenjiang First People's Hospital, Jiangsu, China (Dr Qian); the Divisions of Respiratory Medicine (Drs Chatkin, Zamel, and Silkoff and Ms McClean) and Otolaryngology (Drs Qian and Haight), The Toronto Hospital, University of Toronto, Toronto, Ontario; and the National Jewish Medical and Research Center, Denver, Colo (Dr Silkoff).

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