Table 7

Recommendations for diagnostic tools in rhinoloy

AIMS

METHODS INSTRUMENTS

RECOMMENDATIONS


HISTORY

Evaluation of

* patients' symptoms and symptom severity

* co-morbidities and general medical condition

* medical/surgical history

* exposure to allergens/irritants

* cigarette smoke

* Personal communication

* Questionnaires

Essential part of diagnostic process

In all patients with nasal problems....

and in those with lower respiratory tract disease!


QoL TOOLS

Evaluation of the impact of nasal disease on

* quality of life

* different domains of physical and mental functioning

* Generic

* Disease-specific

Helpful in clinical practice and clinical trials


NASAL EXAMINATION

Evaluation of the

* external and endonasal anatomy

* endonasal mucosa and lumen

* Inspection

* Palpation

* Ant. and post. rhinoscopy

* Nasal endoscopy

* Non-ENT doctors should examine the nose including ant. rhinoscopy

* A nasal endoscopy is recommended in

chronic rhinologic disease


ALLERGY TEST

Evaluation of the sensitization state, including the demonstration of the specific sensitization state

* Skin prick test

* Blood analysis with allergen-specific IgE

Recommended in all patients with clinical suspicion of allergic AW disease


NASAL PROVOCATION TEST

Evaluation of the response of the nasal mucosa to

* allergens

* aspirin

* occupational agents

Provocation by inhalation, spray, nasal drop or discette

Recommended in case of doubt about sensitization


SMELL TEST

Evaluation of the smell capacity

Different tests are currently available

Recommended in case of severe hyposmia or anosmia


TASTE TEST

Evaluation of taste capacity

Electrogustometry

Recommended in patients with taste dysfunction


NASAL PATENCY MEASUREMENTS

Evaluation of a patients' capacity to breathe through the nose

* PNIF

* Anterior rhinomanometry

* Acoustic rhinometry

Recommended parameter in clinical trials

Helpful in clinical practise to evaluate the evolution of nasal patency


NO measurement

Evaluation of NO levels in nasal cavity

Chemiluminiscence reaction of expired air

Helpful as screening tool in PCD


NASAL SAMPLING

Collection of nasal mucosa/cells/secretions for analysis

* Nasal secretions

* Nasal scraping

* Nasal biopsy

Recommendations:

* nasal sampling in experimental/clinical studies

* nasal secretions for B2 transferrin analysis in suspicion of CSF leak

* biopsy in case of unilateral/malignant disease


BLOOD AND ADDITIONAL TESTS

Evaluation of the sensitization state, immune system, endocrine system

Evaluation of mucociliary function

Evalution of chloride content in sweat

* Blood test

* MCT, nasal NO, EM, ciliogenesis in vitro

* Sweat test

Recommended as diagnostic tool in severe rhinitis, rhinosinusitis and nasal polyp disease with suspicion of underlying auto-immune, immunologic or ciliary disease


Scadding et al. Clinical and Translational Allergy 2011 1:2   doi:10.1186/2045-7022-1-2

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