An objective method to record changes in nasal reactivity during treatment of non-allergic nasal hyperreactivity

Non-allergic nasal hyperreactivity is a common problem and many patients suffer from daily symptoms demanding medication. Hitherto there exists no objective method to study congestional changes in clinical practice, to evaluate the efficacy of different therapies. This study is an attempt to develop a method for this purpose. Eleven patients with non-allergic nasal hyperreactivity entered the trial. A histamine challenge model with three different histamine concentrations was used. Recordings of the reactivity of the nasal mucosa were made with rhinostereometry before and after 14 days of topical treatment with budesonide 200 micrograms/day. The results were compared to symptom scores before and after treatment. It was found that there was a significant improvement after treatment both with regard to symptom score and to the recorded reactivity of the nasal mucosa. There was a correlation between symptom score and recorded reactivity before treatment, but not after treatment. The results indicate that the symptom score technique is sufficient in situations where only a semiquantitative method is required. However, when studying changes in the degree of hyperreactivity, the demands for an objective measuring method is greater. The study indicates that the presented method may be adapted for this purpose.