Page 67 - Portuguese Journal - SPORL - Vol 61. Nº1

Table 5
NAPT: Objective criteria – Complementary diagnostic procedures

Objective criteria
- Easy to execute, inexpensive
Peak nasal inspiratory flow (PNIF)
- Dependent on the patient’s collaboration and lung capacity
- Easy and fast execution
Acoustic rhinometry
- Not dependent on the patient’s collaboration
- Sensitive, high specificity
Active anterior rhinomanometry
- Standard method for measuring nasal permeability
Four-phase rhinomanometry - Most reliable method to evaluate nasal permeability and ventilation

Table 6
Positivity in the Nasal Allergen Provocation Test (NAPT)

Method Significant change Moderate change
Subjective Increase of ≥ 5 points in the total score of Increase of ≥ 3 points in the total score
(symptoms) the classification of symptom severity of the classification of symptom severity
Objective Decrease of ≥ 40% in nasal permeability Decrease of ≥ 20% in nasal permeability

5. Treatment This is a phenotypic characteristic of LAR that
An accurate distinction between LAR and contrasts with NAR and may be explained by
NAR is important for the correct therapeutic the clinical and pathophysiological similari-
approach to LAR (Figure 3). Despite the ab- ties between LAR and AR, which include eo-
sence of a study on the efficacy of allergen sinophilic inflammatory infiltrate and reacti-
elimination and pharmacotherapy in patients vity to allergens. An observational study and
with LAR, an improvement in the symptoms four double-blind clinical trials, controlled by
has been reported with topical nasal corticos- placebo, 21-24 showed an improvement in LAR
teroids and oral and topical antihistamines 3-4,10 . with the use of specific immunotherapy (IT)

Figure 3
Therapeutic approach to local allergic rhinitis IT, immunotherapy.

Volume 61 . Nº1 . March 2023 67