Diagnosing nasal hyperreactivity with positional rhinomanometry

Positional rhinomanometry is a physiologic method for estimating nasal resistance, which is variable, difficult to predict, and linked to vasomotor activity of the functional system culminating in the turbinate valves. Thirty subjects suffering from allergic rhinitis, 25 patients affected by aspecific rhinitis, and 40 healthy controls underwent positional rhinomanometry. Test positions included the seated (baseline), supine, and recumbent (homolateral and contralateral to the nasal fossa under examination). In patients with perennial allergic rhinitis and in those with aspecific rhinitis, positional rhinomanometry elicited two pathologic responses: either an average percentage rise of more than 80% in nasal resistance in the supine and homolateral and contralateral recumbent positions compared with basal values, or a paradoxical fall in the supine and homolateral recumbent positions.