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Updated: May 12, 2026

Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
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Nasal provocation test using allergen extract versus cold dry air provocation test: which and when?

Young Hyo Kim1, Tae Young Jang

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Republic of Korea.

American Journal of Rhinology & Allergy
|April 9, 2013
PubMed
Summary

Nasal provocation tests (NPTs) and cold dry air (CDA) tests evaluate nasal hyperreactivity. CDA is a useful adjunct for assessing nonspecific nasal hyperreactivity in patients reporting subjective cold hyperresponsiveness.

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Area of Science:

  • Otolaryngology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Nasal provocation tests (NPTs) are valuable for diagnosing allergic rhinitis.
  • Cold dry air (CDA) provocation is used to assess nonspecific nasal hyperreactivity (NHR).
  • Clinical utility varies between NPT and CDA for different patient profiles.

Purpose of the Study:

  • To compare the efficacy of NPT versus CDA provocation.
  • To determine which test is more suitable for patients with distinct clinical presentations.
  • To evaluate objective and subjective nasal symptom changes.

Main Methods:

  • Evaluated nasal symptoms (VAS) and acoustic parameters in healthy volunteers, allergic rhinitis patients, and nonallergic rhinitis subjects.
  • Compared changes after NPT and CDA provocation based on subjective cold hyperresponsiveness (SCH).
  • Analyzed correlations between skin-prick test (SPT) results and VAS changes, and between NPT and CDA outcomes.

Main Results:

  • NPT significantly increased rhinorrhea, sneezing, and itching in allergic rhinitis patients.
  • CDA challenge led to greater nasal obstruction in nonallergic rhinitis patients.
  • Both NPT and CDA showed significant changes in acoustic parameters, with CDA being more sensitive in SCH+ individuals.

Conclusions:

  • CDA can serve as a supplementary tool for evaluating NHR.
  • CDA is particularly useful for patients reporting subjective cold hyperresponsiveness.
  • NPT and CDA provocation tests offer distinct diagnostic insights.