Postnasal drip syndrome: A new definition and successful oral gargling treatment

Abstract

Introduction: Many patients visit the rhinology clinic with complaints of postnasal drip (PND), a condition initially termed postnasal drip syndrome (PNDS) but today is known as upper airway cough syndrome (UACS). However, some patients complain only of discomfort caused by PND without cough and exhibit no definite endoscopic evidence of nasal secretions or PND. We investigated the correlation between endoscopic findings and symptoms and evaluate the effectiveness of oral gargling for PND patients without cough. Materials and methods: We retrospectively reviewed the medical records of PND patients who underwent oral gargling. Patients with PND as their only nasal symptom were included. Oral gargling was prescribed for all patients. Objective endoscopic examinations were also conducted. Discomfort caused by PND was assessed using questionnaires, specifically the Sino-Nasal Outcome Test22 (SNOT-22) score and the scores on the post-nasal drip symptom sheet (PNDSS). Results: Oral gargling with normal saline for 12 weeks led to significant improvements in PNDS patients. The mean SNOT-22 score and the PNDSS score decreased significantly. However, no correlation was found between the endoscopic findings and either the SNOT-22 or PNDSS score. No severe complications were reported. Conclusions: Oral gargling may be a safe and potentially effective treatment for PNDS. It could help dilute and remove mucus from the nasopharynx and oropharynx. We propose a new definition for PNDS: a sensation of PND without cough in the absence of any sinonasal disease, irrespective of endoscopic findings.