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Table 7 Recommendations for diagnostic tools in rhinoloy

From: Diagnostic tools in Rhinology EAACI position paper

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
* 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