Active anterior rhinomanometry: A study on nasal airway resistance, paradoxical reactions to decongestion, and repeatability in healthy subjects

OBJECTIVES: Anterior active rhinomanometry (AAR) is widely used in Swedish routine clinical practice to decide if septoplasty is necessary. The scientific basis for the method needs to be strengthened. Therefore, the aims were to evaluate nasal airway resistance (NAR), paradoxical reactions to pharmacological decongestion, and test–retest characteristics of the Rhino‐Comp® AAR in healthy subjects. METHODS: A prospective longitudinal design was used. AAR was performed before and after decongestion at baseline and after ≥6 months on 60 healthy volunteers. The relationships between NAR, height, weight, BMI, sex, and allergic rhinitis were evaluated by regression analyses. Descriptive statistics were used to evaluate paradoxical reactions. Test–retest and repeatability characteristics were evaluated with intra‐class coefficients (ICC), Cronbach's α, and standard error of measurement RESULTS: No statistically significant differences were found between genders or nasal cavity sides. NAR was statistically significantly related to height. Short‐ and long‐term test–retest characteristics were good with ICC and Cronbach's α > .75. The minimal significant difference in NAR Log10V2 values between the two measurements was 0.11 and 0.09 (long‐ and short‐term). Paradoxical reactions to pharmacological decongestion were rare, mostly weak, and not evidently reproducible. CONCLUSION: In this study, we report reference data for healthy subjects, test–retest capabilities, and the minimal relevant difference between two measurements for the Rhino‐Comp® AAR, information that is vital and necessary for the appropriate use of AAR in clinical practice. An effective method for pharmacological decongestion is described and recommended for future studies and clinical practice. Paradoxical reactions to pharmacological decongestants exist but maybe without clinical significance. LEVEL OF EVIDENCE: NA.