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March 1972

Glucose in Nasal Secretions: Diagnostic Significance

Author Affiliations

Galveston, Tex
From the departments of otolaryngology (Drs. Kosoy, Winkelmann, and Bailey) and preventive medicine and community health (Dr. Trieff), University of Texas Medical Branch, Galveston. Dr. Kosoy is currently at Maxwell Air Force Base, Montgomery, Ala.

Arch Otolaryngol. 1972;95(3):225-229. doi:10.1001/archotol.1972.00770080367008

Analysis of nasal secretions for glucose with glucose-oxidase test paper systems (Clinistix or Tes-Tape) is widely used clinically to confirm the presence of cerebrospinal fluid (CSF) rhinorrhea. Studies on 164 subjects, without CSF rhinorrhea (72 normals and 92 patients with allergic or infectious rhinosinusitis) demonstrated a significant percentage with positive reactions for glucose. This in vivo testing of nasal secretions is not a reliable indicator of CSF rhinorrhea when used as a single test criterion. In vitro testing gives fewer false positives than in vivo testing, but the former is still felt to be unreliable as a single indicator of CSF rhinorrhea, particularly in the presence of allergic or infectious rhinosinusitis. Actual quantitative values of glucose in nasal secretions of normal and allergic patients are less than 10 mg/100 ml, which is below the level of sensitivity for Clinistix and Tes-Tape. The glucose derivatives known to exist in normal mucoproteins were tested and ruled out as an interference for in vitro analyses of glucose.

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