Proposed diagnostic standard using visual analogue scale and acoustic rhinometry in nasal provocation test in allergic patients

Abstract

Objective The authors aimed to analyze symptom change after nasal provocation and acoustic rhinometry results of a larger number of allergic rhinitis patients and also aimed to propose a new diagnostic threshold by investigating the difference between patients with allergic and non-allergic perennial rhinitis. Methods The authors checked symptom change and performed acoustic rhinometry before and after nasal provocation in 208 patients (114 males and 94 females, 19–58 years old) with allergic rhinitis and 222 patients (116 males and 106 females, 20–74 years old) clinically diagnosed with non-allergic perennial rhinitis (control group). Then the authors compared VAS (visual analogue scale), TNV (total nasal volume), MCA (minimal cross-sectional area), length of MCA and change of these values between allergic patients group and control group, to propose the new diagnostic standard. Results The change of symptom score and number of sneezing after nasal provocation were significantly different between allergic patient and control group. The basal TNV, MCA, length of MCA, and changes of these values were also significantly different. By drawing the ROC (receiver operator characteristic) curve and evaluating the sensitivity and specificity for each criteria, we could set the diagnostic criteria as follows: (1) symptom change: more than 2 points in the case of nasal obstruction and more than 1 point for the case of rhinorrhea or itching, (2) more than 24.5% change of the TNV, and (3) more than 20% change of the MCA. Conclusion VAS change and acoustic rhinometry in nasal provocation test could be a valuable tool in diagnosing allergic rhinitis with high sensitivity and specificity.