Table 7 Recommendations for diagnostic tools in rhinoloy
| Â | 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 |