Nasal Airflow Measured by Rhinomanometry Correlates with FeNO in Children with Asthma

PLoS One. 2016 Oct 28;11(10):e0165440. doi: 10.1371/journal.pone.0165440. eCollection 2016.

Abstract

Background: Rhinitis and asthma share similar immunopathological features. Rhinomanometry is an important test used to assess nasal function and spirometry is an important tool used in asthmatic children. The degree to which the readouts of these tests are correlated has yet to be established. We sought to clarify the relationship between rhinomanometry measurements, fractional exhaled nitric oxide (FeNO), and spirometric measurements in asthmatic children.

Methods: Patients' inclusion criteria: age between 5 and 18 years, history of asthma with nasal symptoms, and no anatomical deformities. All participants underwent rhinomanometric evaluations and pulmonary function and FeNO tests.

Results: Total 84 children were enrolled. By rhinomanometry, the degree of nasal obstruction was characterized as follows: (1) no obstruction in 33 children, (2) slight obstruction in 29 children, and (3) moderate obstruction in 22 children. FeNO was significantly lower in patients without obstruction than those with slight or moderate obstruction. Dividing patients according to ATS Clinical Practice Guidelines regarding FeNO, patients < 12 years with FeNO > 20 ppb had a lower total nasal airflow rate than those with FeNO < 20 ppb. Patients ≥ 12 years with FeNO > 25 ppb had a lower total nasal airflow rate than those with FeNO < 25 ppb.

Conclusions: Higher FeNO was associated with a lower nasal airflow and higher nasal resistance. This supports a relationship between upper and lower airway inflammation, as assessed by rhinomanometry and FeNO. The results suggest that rhinomanometry may be integrated as part of the functional assessment of asthma.

MeSH terms

  • Adolescent
  • Asthma / blood
  • Asthma / complications
  • Asthma / diagnosis*
  • Asthma / physiopathology*
  • Child
  • Child, Preschool
  • Exhalation*
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Nitric Oxide / metabolism*
  • Nose / physiopathology*
  • Pulmonary Ventilation*
  • Rhinitis, Allergic / complications
  • Rhinomanometry*
  • Spirometry
  • Surveys and Questionnaires

Substances

  • Nitric Oxide
  • Immunoglobulin E

Grants and funding

This research was supported by the grant from the Kaohsiung Medical University Hospital, Taiwan (KMUH-2M30). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.