The Nasal Endoscopic Features of Postnasal Drip: A Cross Sectional Study

Area of Science:

• Otorhinolaryngology
• Clinical Rhinology
• Diagnostic Endoscopy

Background:

• Chronic rhinitis frequently causes bothersome postnasal drip (PND), a symptom inadequately addressed in clinical practice.
• Nasal endoscopy is a potential tool for identifying PND, with described features including posterior nasal cavity secretions, diffuse nasopharyngeal erythema, and hemorrhagic spots.
• These endoscopic findings have not been systematically studied in relation to PND.

Purpose of the Study:

• To evaluate the association between specific nasal endoscopic features and the presence of PND in patients diagnosed with rhinitis.
• To provide clinicians with guidance for interpreting nasal endoscopic findings in the context of PND.

Main Methods:

• Adult patients (≥18 years) with chronic rhinitis were recruited from an Otorhinolaryngology outpatient clinic.
• Patients were categorized into two groups: 'Rhinitis with PND' and 'Rhinitis only'.
• Nasal endoscopic features, including posterior nasal cavity secretions, nasopharyngeal erythema (none, roof only, diffuse), and hemorrhagic spots, were assessed and compared between groups.

Main Results:

• Of 98 patients (mean age 32.3 ± 11.3 years, 61.2% female), 61.2% had PND.
• The presence of secretions in the posterior nasal cavity was significantly associated with PND (78.3% vs. 55.3%, p=0.02, OR=2.81).
• Diffuse nasopharyngeal erythema was more common in the 'Rhinitis only' group (76.3% vs. 53.3%, p=0.02), while hemorrhagic spots were similarly present in both groups (11.7% vs. 18.4%, p=0.35).

Conclusions:

• Posterior nasal cavity secretions observed during endoscopy may serve as an indicator of bothersome PND in rhinitis patients.
• Diffuse nasopharyngeal erythema and hemorrhagic spots appear to be nonspecific signs of inflammation rather than direct indicators of PND.