Study the Role of Nasal Scrap Cytology in Allergic Rhinitis Patients in Rural Population

  • Puneet Singhvi
  • Nitish Baisakhiya
  • Gurchand SinghEmail author
Original Article


Allergic Rhinitis is one of the gift of modern era. Condition is involving wide range of age group starting from children to old age people. In spite of latest diagnostic facility and advanced treatment, it is still a great challenge for the otorhinolaryngologist. This study was done to perform simple and cost effective test to understand the severity of Allergic Rhinitis. To investigate the patients of allergic rhinitis with specific focus on nasal scrape cytology. After applying inclusion and exclusion criterion were found suitable and hence selected for the present study. 100 patients who were clinically diagnosed on history and examination as allergic rhinitis were included as cases while control group consisted of 100 subjects having no symptoms of allergic rhinitis. These patients were a subjected to nasal scrape cytology for which Cytobrush Plus (Medscand Cell Sampling Kit), Malmo, Sweden, was employed. Mucosal specimens were acquired by scraping the surfaces of the middle thirds of inferior turbinates with Cytobrush Plus (Medscand Cell Sampling Kit), Malmo, Sweden. The samples thus obtained were transferred onto glass slides to be fixed in 95% ethyl alcohol and stained with May Gurwald Gimesa stain to study pattern and profile of different types of cells like eosinophils, goblet cells, mast cells. The nasal eosinophils were studied under 1000 × magnification of light microscope 10-well spread, high power epithelium fields were examined and the quantitative score of nasal eosinophils was rated according to a scale described by Meltzer. In study group all 100 patients underwent nasal scrape cytology. 25 (25%) patients in study group showed grade 1 + nasal eosinophilia followed by grade ½ + in 24 (24%), grade 0 in 22 (22%) and grade 2 + in 21 (21%). In control group 80% of subjects had grade 0 nasal eosinophilia. Difference between nasal eosinophilia in the study and the control group were found to be statistically significant. In study group 54% showed grading > 0.5 + whereas 46% showed ≤ 0.5 + . The sensitivity and specificity were observed to be 54% and 100% respectively. The results thus found were statistically significant. Nasal scrape cytology which was an added dimension proved to be a more specific than sensitive test. The specificity of nasal scrape cytology in our study was 100%. Sensitivity was only 54%. 22% of the patients of allergic rhinitis showed an eosinophil count more than 300/cu mm.


Allergic rhinitis Nasal scraping Eosinophils 


  1. 1.
    Renfro BL (1992) Paediatric otolaryngic allergy. Otolaryngol Clin N Am 25(1):181–196Google Scholar
  2. 2.
    Derebery MJ, Berlinger KI (1998) Allergy for otologist. Otolaryngol Clin N Am 31(1):157–173CrossRefGoogle Scholar
  3. 3.
    Virant FS (2000) Allergic rhinitis. Immunol Allergy Clin N Am 2(2):265–282CrossRefGoogle Scholar
  4. 4.
    Meltzer EO (1988) Evaluating rhinitis: clinical, rhinomanometric and cytology assessments. J Allergy Clin Immunol 82:900–908CrossRefGoogle Scholar
  5. 5.
    Sood A (2005) Diagnostic significance of nasal eosinophilia in allergic rhinitis. Indian J Otolaryngol Head Neck Surg 57(1):13–16CrossRefGoogle Scholar
  6. 6.
    Weiner JM, Abramson MJ, Puy RM (1998) Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomized controlled trials. BMJ 317:1624–1629CrossRefGoogle Scholar
  7. 7.
    Varghese BT, Murthy PSN, Ranjan R (2000) Clinico-pathological correlation between allergic rhinitis and bronchial asthma. J Laryngol Otol 114:354–358CrossRefGoogle Scholar
  8. 8.
    Kirtsreesakul V, Ruttanaphol S (2008) The relationship between allergy and rhinosinusitis. Rhinology 46:204–208PubMedGoogle Scholar
  9. 9.
    Ebert CS Jr, Pillsbury HC III (2011) Epidemiology of allergy. Otolaryngol Clin N Am 44:537–548CrossRefGoogle Scholar
  10. 10.
    Gaur SN, Gupta K, Rajpal S, Singh AB, Rohatgi A (2006) Prevalence of bronchial asthma and allergic rhinitis among urban and rural adult population of Delhi. Indian J Allergy Asthma Immunol 20(2):90–97Google Scholar
  11. 11.
    Lasisi AO, Lawal HO, Ogun GO et al (2010) Correlation between eosinophilia and nasal features in allergic rhinosinusitis. J Asthma Allergy Educ 1:219–222CrossRefGoogle Scholar
  12. 12.
    Yadav J, Verma A, Singh J (2003) Study on nasal mucous clearance in patients of perennial allergic rhinitis. Indian J Allergy Asthma Immunol 17(2):89–91Google Scholar
  13. 13.
    Jang AS (2002) Nasal eosinophilic inflammation contributes to bronchial hyperresponsiveness in patients with allergic rhinitis. J Korean Med Sci 17:761–764CrossRefGoogle Scholar
  14. 14.
    Farhoudi A, Razavi A, Chavoshzadeh Z et al (2005) Descriptive study of 226 patients with allergic rhinitis and asthma. Iran J Allergy Asthma Immunol 4(2):99–101PubMedGoogle Scholar
  15. 15.
    Dold S, Wjst M, Mutius EV, Reitmeir P, Stiepel E (1992) Genetic risk for asthma, allergic rhinitis, and atopic dermatitis. Arch Dis Child 67:1018–1022CrossRefGoogle Scholar
  16. 16.
    Miller RE, Paradise JL, Friday GA et al (1982) The nasal smear for eosinophils, its value in children with seasonal allergic rhinitis. Am J Dis Child 136:1009–1011CrossRefGoogle Scholar
  17. 17.
    Bakhshaee M, Fereidouni M, Farzadnia M, Varasteh AR (2010) The nasal smear for eosinophils, it’s value, and it’s relation to nasal mucosal eosinophilia in allergic rhinitis. Iran J Otorhinolaryngol 22(60):73–78Google Scholar
  18. 18.
    Lans DM, Alfano N, Rocklin R (1989) Nasal eosinophilia in allergic and non allergic rhinitis usefulness of the nasal smear in the diagnosis of allergic rhinitis. Allergy Proc 10:275–280CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  • Puneet Singhvi
    • 1
  • Nitish Baisakhiya
    • 2
  • Gurchand Singh
    • 2
    Email author
  1. 1.ENT SurgeonMaitri HospitalKotaIndia
  2. 2.Department of ENTMMIMSRMullana, AmbalaIndia

Personalised recommendations