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Acoustic Rhinometry in Nasal Provocation Tests in Children and Adolescents.

G F Wandalsen1, A I Mendes1, F Matsumoto1

  • 1Division of Allergy and Clinical Immunology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.

Journal of Investigational Allergology & Clinical Immunology
|June 22, 2016
PubMed
Summary

Acoustic rhinometry (AR) is a sensitive tool for monitoring nasal responses in children and adolescents during histamine nasal provocation tests (NPTs). A 19%-21% drop in nasal volume (V5) is the optimal cutoff for concluding the NPT.

Keywords:
Acoustic rhinometryAirway resistanceHistamineNasal cavityNasal provocation testsRhinitisRhinomanometry

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Area of Science:

  • Otolaryngology
  • Allergy and Immunology
  • Pediatric Respiratory Medicine

Background:

  • Histamine nasal provocation tests (NPTs) are used to assess allergic rhinitis.
  • Standardization of objective measurements during NPTs in children is needed.
  • Acoustic rhinometry (AR) offers a non-invasive method to evaluate nasal airflow and volume.

Purpose of the Study:

  • To standardize acoustic rhinometry (AR) for use in histamine nasal provocation tests (NPTs) in pediatric populations.
  • To compare the efficacy of AR with anterior active rhinomanometry (AAR) in detecting nasal changes during NPTs.
  • To determine the optimal AR parameters for concluding an NPT in children and adolescents.

Main Methods:

  • A cross-sectional validation study was conducted comparing AR and AAR in 20 children/adolescents with allergic rhinitis and 20 controls.
  • Histamine NPTs were performed, measuring changes in total nasal resistance (AAR) and nasal volume in the first 5 cm (V5) using AR.
  • Sensitivity and specificity of AR parameters were evaluated against AAR criteria.

Main Results:

  • Patients with allergic rhinitis exhibited higher baseline nasal resistance and lower V5 compared to controls.
  • The mean histamine concentration required to double nasal resistance was significantly lower in the rhinitis group.
  • A 19%-21% decrease in V5, measured by AR, demonstrated high sensitivity and specificity in identifying significant nasal response during NPTs.

Conclusions:

  • Acoustic rhinometry (AR) is a feasible and sensitive method for monitoring nasal responses in pediatric histamine NPTs.
  • A cutoff of a 19%-21% drop in V5 is recommended for concluding NPTs in children and adolescents.
  • AR provides objective and reliable data for the assessment of allergic rhinitis in pediatric patients.