Distilled water nasal provocation in hyperreactive patients.

Area of Science:

• Otolaryngology
• Allergology
• Pulmonology

Background:

• Nonisotonic aerosols can trigger upper and lower airway hyperreactivity.
• Nasal hyperreactivity is a key feature in various sinonasal conditions.

Purpose of the Study:

• To compare distilled water nasal challenge results in allergic rhinitis versus noninfective nonallergic rhinitis (NINAR).
• To assess the clinical utility of distilled water provocation for evaluating nasal hyperreactivity and therapy success.

Main Methods:

• 68 ambulatory patients (allergic rhinitis or NINAR) underwent nasal provocation with 10 mL distilled water aerosol.
• Active anterior rhinomanometry was performed before and after provocation to measure nasal resistance.
• A subset of allergic patients received 2-week antihistamine and topical steroid therapy before repeat measurements.

Main Results:

• Distilled water aerosol significantly increased nasal resistance in both allergic rhinitis and NINAR patients.
• Total nasal airway resistance (NAR) significantly increased in NINAR patients post-provocation.
• Therapy with antihistamines and topical steroids significantly reduced nasal hyperreactivity in allergic rhinitis patients.

Conclusions:

• Distilled water nasal provocation is a simple, cost-effective method to assess nonspecific nasal hyperreactivity.
• This method provides valuable clinical data for diagnosing and monitoring sinonasal hyperreactive conditions.
• The study demonstrates the efficacy of combined antihistamine and topical steroid therapy in managing nasal hyperreactivity.