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Table 4 Practical aspects of ASNC

From: Diagnostic tools in Rhinology EAACI position paper

PURPOSES

CONTRAINDICATIONS

Demonstration of the causal role of an allergen

Identification of the most relevant allergen(s)

Evaluation of the effect of a treatment

Investigating the inflammatory phenomena (research)

Occupational rhinitis

Acute bacterial or viral rhinosinusitis.

Acute exacerbation of allergic disease.

History of previous anaphylactic reaction

Severe general diseases

Pregnancy

Polyps

Recent ENT surgery (6-8 wks)

CAUSES OF FALSE POSITIVE

CAUSES OF FALSE NEGATIVE

Nasal cycle

Recent exposure to irritants

Rhinosinusitis

Priming effect

Weak extract

Drugs

nasal antihistamine (1 day withdrawal)

oral antihistamine (3 day withdrawal)

nasal steroid (7 day withdrawal)

  1. GENERAL PROCEDURE
  2. Let the patient be adapted to room temperature
  3. Inspect nasal cavity
  4. Spray or apply saline as negative control
  5. Perform measurement(s)
  6. Instruct to avoid nasal breathing
  7. Apply the allergen into one nostril and re-evaluate after 10-15 minutes
  8. Proceed on with increasing concentration in the other nostril
  9. Use both active and plasebo tests for diagnosis for occupational rhinitis
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Clinical and Translational Allergy

ISSN: 2045-7022

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