Selected methodological aspect and clinical applications of rhinomanometry in allergic rhinitis

Radoslaw Spiewak

Doctoral thesis, defended in Lublin on 21 March 1995.
75 pages + annex with numerical data (57 pages), 47 tables, 19 figures, 140 references.

This work was awarded with:

Honours from the Scientific Council of the Institute of Agricultural Medicine in Lublin (21 March 1995).
The Professor Mieczyslaw Obtulowicz Honorary Diploma
(Executive Committee of the Polish Allergology Society, 21 November 1997).

Abstract

Introduction

Rhinomanometry is a method of measuring nasal airflow and nasal resistance. Despite many technical improvements, there are conflicting opinions on its applicability in the functional diagnosis of the upper airway.

Aim

The study was aimed at the assessment of the anterior active rhinomanometry in the diagnosis and monitoring of allergic rhinitis (AR), allergy vaccination, and pharmacotherapy.

Material and Methods

The study population consisted of 563 patients with allergic rhinitis and 49 controls. The following items were analysed:

influence of sex , age and the side of performing on rhinomanometry results,
optimal conditions for performing rhinomanometry in patients with AR,
spontaneous variability of nasal patency in the symptomatic and asymptomatic phase of AR,
correlation between rhinomanometry results and clinical symptoms of AR, and rhinoscopy results,
values nasal flow and resistance limiting the comfortable breathing through the nose (nasal comfort limiting values),
applicability of rhinomanometry in monitoring allergy vaccination (specific immunotherapy) with allergens,
its use in monitoring pharmacotherapy of arterial hypertension on the example of the ACE-inhibitor captopril,
sensitivity and specificity of rhinomanometrically controlled diagnostic nasal provocations.

New indexes derived from the raw data were proposed. Own algorithms (computer programs) were used for assessing the reproducibility of measurements and in calculating the nasal comfort limiting values.

Results

There was no significant influence on the rhinomanometry results by the patient's gender and the test side. Nasal resistance was increasing with age (r=0.23; p=0.008). There was a mediocre correlation between nasal resistance and the feeling of nasal blockage (r=0,58; p=0,001), as well as between the asymmetry of nasal flow and the presence of septum deviation in anterior rhinoscopy (r=0,345; p=0,048). Cyclic changes of nasal patency were demonstrated. The nasal comfort limiting values were: nasal flow of 280 cm³ s^-1 and nasal resistance of 0,18 Pa cm^-3 s (they may be used e.g. in disabilities certification). Using rhinomanometry, it was possible to detect a decrease of nasal patency after injection of a single dose of allergy vaccine (use: monitoring allergy vaccination). Also possible was rhinomanometric detection of the decrease in nasal patency after taking a singe dose of captopril (use: fast, non-invasive and inexpensive monitoring of hypertension pharmacotherapy). A low sensitivity and specificity was demonstrated of the rhinomanometry-controlled nasal provocations carried out according to present criteria and appropriate changes were proposed.

Conclusions

Rhinomanometry provides valuable information in the diagnosis and monitoring of allergic rhinitis.
A new potential use of the method is the monitoring of allergy vaccination (specific immunotherapy), and the monitoring of therapy with antihypertensive drugs.

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Document created: 6 May 2004, last updated: 16 June 2017.