Rhinosinusitis, laryngopharyngeal reflux and cough: an ENT viewpoint

Chronic cough is a common presentation. Postnasal drip (PND) and gastro-oesophageal reflux are mostly implicated in the aetiology. Directly examining the larynx can often help to demonstrate laryngitis or inter-arytenoid oedema that is mostly attributed to reflux. Although "the syndrome of postnasal drip" is considered as a major cause for chronic cough, evidence of its existence is mostly difficult to elicit on examination. Furthermore, the majority of patients with "postnasal drip" seen in ENT outpatients do not complain of cough. Evidence does suggest there is a link between postnasal drip and cough. The fact that some patients present with cough in association with this syndrome and others do not is still not well understood.