Acoustic Rhinometry in Nasal Provocation Tests in Children and Adolescents.
OBJECTIVE
To standardize acoustic rhinometry (AR) in nasal provocation tests (NPTs) with histamine in children and adolescents.


METHODS
We performed a cross-sectional validation to compare AR with anterior active rhinomanometry (AAR) during histamine NPT in 20 children and adolescents with persistent allergic rhinitis and 20 controls. Changes in total nasal resistance (AAR) were compared with changes in nasal volume in the first 5 cm (V5).


RESULTS
Compared with controls, patients with rhinitis had significantly higher mean total nasal resistance (0.34 Pa/cm3/s vs 0.21 Pa/cm3/s; P=.01) and lower mean V5 values (8.20 cm3 vs 9.24 cm3; P=.04) at baseline. The mean histamine concentration necessary to increase total nasal resistance by at least 100% was significantly lower in the rhinitis group than in the control group (0.72 mg/mL vs 2.4 mg/mL; P<.001). At the end of the NPT a mean increase of 126% in total nasal resistance and a mean decrease of 24.3% in V5 were observed in the rhinitis group. When compared with the AAR criteria, the highest sensitivity and specificity values were observed for a cutoff represented by a 19%-21% drop in V5.


CONCLUSIONS
We found AR to be a feasible and sensitive tool for monitoring nasal response in children and adolescents undergoing histamine NPT. The best AR cutoff for ending the NPT was a 19%-21% drop in V5.
Division of Allergy and Clinical Immunology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
G F
GF
Wandalsen
Division of Allergy and Clinical Immunology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
A I
AI
Mendes
Division of Allergy and Clinical Immunology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
F
F
Matsumoto
Division of Allergy and Clinical Immunology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
D
D
Solé
D000293:Adolescent; D000403:Airway Resistance; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009299:Nasal Provocation Tests; D065631:Rhinitis, Allergic / Q000175:diagnosis*; D023842:Rhinometry, Acoustic
Acoustic rhinometry; Airway resistance; Histamine; Nasal cavity; Nasal provocation tests; Rhinitis; Rhinomanometry