Filter Paper Test to Assess Nasal Hyperreactivity

Sung, Jong Hwa; Jeong, Jae Ho; Jeon, Sea Yuong; Hwang, Eui Gee

Abstract

BACKGROUND AND OBJECTIVES: We can evaluate nasal hyperreactivity with histamine challenge test (HCT) or metacholine test. In 1981, a simple and reproducible technique using filter paper to collect nasal secretion was introduced. We revised this technique to assess nasal hyperreactivity. The basic concept of the test is that filter paper in the nose acts as a mechanical stimulus to the nasal mucosa, and causes nasal secretion, which is absorbed in the filter paper. The aim of this study was to present filter paper test (FPT) as an objective assessment of nasal hyperreactivity in allergic patients. We compared the sensitivity and the specificity of FPT with HCT, and also evaluated the validity of FPT in assessing the changes of nasal hyperreactivity.
SUBJECTS AND METHOD
For FPT, a folded strip of filter paper in 50X6 mm was placed between the septum and the inferior turbinate, and the wetted strip was weighed after 10 minutes. For HCT, a paper disk, saturated with histamine solution (1 mg/ml) was placed on the anterior end of the inferior turbinate, and the number of sneezing was counted per minute. Twenty nine patients with allergic rhinitis and hyperreactive nasal symptoms and 20 normal subjects were included in the study. Fourteen out of the 29 hyperreactive and allergic rhinitis patients were subjected to the evaluation of changes in the amount of nasal secretion.
RESULTS
For FPT, sensitivity was 65.5% and specificity was 95%, whereas for HCT, the sensitivity was 69% and specificity was 95%. After systemic steroid treatment, the amount of nasal secretion was decreased significantly.
CONCLUSION
FPT showed almost the same sensitivity and the specificity compared to HCT, and appeared to be a valid test to assess the nasal hyperreactivity. These findings imply that FPT is technically easy and reliable, and a valid test to assess nasal hyperreactivity in allergic patients.