Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features

Abstract Objective Postnasal drip (PND) is a common symptom that is difficult to verify with a traditional examination. Nasal endoscopy has the potential to improve the diagnostic process by confirming the presence and location of mucus. This study sought to describe the association of specific feat...

Full description

Saved in:
Bibliographic Details
Main Authors: Jenilkumar H. Patel, Nicholas Mankowski, Robbie A. Beyl, Manal S. Malik, Andrew Parker, Edward D. McCoul
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:OTO Open
Subjects:
Online Access:https://doi.org/10.1002/oto2.70094
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849473548550144000
author Jenilkumar H. Patel
Nicholas Mankowski
Robbie A. Beyl
Manal S. Malik
Andrew Parker
Edward D. McCoul
author_facet Jenilkumar H. Patel
Nicholas Mankowski
Robbie A. Beyl
Manal S. Malik
Andrew Parker
Edward D. McCoul
author_sort Jenilkumar H. Patel
collection DOAJ
description Abstract Objective Postnasal drip (PND) is a common symptom that is difficult to verify with a traditional examination. Nasal endoscopy has the potential to improve the diagnostic process by confirming the presence and location of mucus. This study sought to describe the association of specific features of PND on nasal endoscopy with other clinical features. Study Design Cross‐sectional with prospective data collection. Setting Outpatient rhinology practice. Methods Data were prospectively collected on adult (≥18 years of age) patients with PND who underwent nasal endoscopy over a 6‐month period. Variables of interest included reflux‐related symptoms, nasal congestion, hyposmia, rhinorrhea, pruritic symptoms, inferior turbinate (IT) hypertrophy, 22‐item sinonasal outcome test (SNOT‐22) scores, and diagnoses of allergic rhinitis (AR), chronic rhinosinusitis (CRS), and reflux disease. Presence of mucus was designated at the nasal cavity (NC) floor, posterior IT, middle meatus (MM), and sphenoethmoidal recess (SER), and consistency of thick or thin was assigned during nasal endoscopy. Results Of 118 patients, 112 (94.9%) had identifiable mucus on nasal endoscopy. MM/SER mucus was associated with SNOT‐22 score ≥ 50, diagnosis of CRS, and absence of IT hypertrophy or diagnosis of AR. NC and IT mucus was associated with nasal congestion, rhinorrhea, pruritic symptoms, IT hypertrophy, AR, and absence of CRS. Thick NC/IT mucus was associated with reflux symptoms. Conclusion Great majority of patients who report PND have posterior nasal drainage of abnormal mucus that can be directly observed with nasal endoscopy. Clinicians should be encouraged to utilize nasal endoscopy when available to evaluate patients with PND.
format Article
id doaj-art-9f44c2c2ca8244ce8635d7f3433a44c7
institution Kabale University
issn 2473-974X
language English
publishDate 2025-04-01
publisher Wiley
record_format Article
series OTO Open
spelling doaj-art-9f44c2c2ca8244ce8635d7f3433a44c72025-08-20T03:24:07ZengWileyOTO Open2473-974X2025-04-0192n/an/a10.1002/oto2.70094Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical FeaturesJenilkumar H. Patel0Nicholas Mankowski1Robbie A. Beyl2Manal S. Malik3Andrew Parker4Edward D. McCoul5Department of Otolaryngology Tulane University School of Medicine New Orleans Louisiana USADepartment of Otolaryngology Tulane University School of Medicine New Orleans Louisiana USAPennington Biomedical Research Center Baton Rouge Louisiana USADepartment of Otolaryngology Tulane University School of Medicine New Orleans Louisiana USADepartment of Otolaryngology Tulane University School of Medicine New Orleans Louisiana USADepartment of Otolaryngology Tulane University School of Medicine New Orleans Louisiana USAAbstract Objective Postnasal drip (PND) is a common symptom that is difficult to verify with a traditional examination. Nasal endoscopy has the potential to improve the diagnostic process by confirming the presence and location of mucus. This study sought to describe the association of specific features of PND on nasal endoscopy with other clinical features. Study Design Cross‐sectional with prospective data collection. Setting Outpatient rhinology practice. Methods Data were prospectively collected on adult (≥18 years of age) patients with PND who underwent nasal endoscopy over a 6‐month period. Variables of interest included reflux‐related symptoms, nasal congestion, hyposmia, rhinorrhea, pruritic symptoms, inferior turbinate (IT) hypertrophy, 22‐item sinonasal outcome test (SNOT‐22) scores, and diagnoses of allergic rhinitis (AR), chronic rhinosinusitis (CRS), and reflux disease. Presence of mucus was designated at the nasal cavity (NC) floor, posterior IT, middle meatus (MM), and sphenoethmoidal recess (SER), and consistency of thick or thin was assigned during nasal endoscopy. Results Of 118 patients, 112 (94.9%) had identifiable mucus on nasal endoscopy. MM/SER mucus was associated with SNOT‐22 score ≥ 50, diagnosis of CRS, and absence of IT hypertrophy or diagnosis of AR. NC and IT mucus was associated with nasal congestion, rhinorrhea, pruritic symptoms, IT hypertrophy, AR, and absence of CRS. Thick NC/IT mucus was associated with reflux symptoms. Conclusion Great majority of patients who report PND have posterior nasal drainage of abnormal mucus that can be directly observed with nasal endoscopy. Clinicians should be encouraged to utilize nasal endoscopy when available to evaluate patients with PND.https://doi.org/10.1002/oto2.70094diagnosisnasal endoscopypostnasal driprefluxrhinitissinusitis
spellingShingle Jenilkumar H. Patel
Nicholas Mankowski
Robbie A. Beyl
Manal S. Malik
Andrew Parker
Edward D. McCoul
Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features
OTO Open
diagnosis
nasal endoscopy
postnasal drip
reflux
rhinitis
sinusitis
title Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features
title_full Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features
title_fullStr Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features
title_full_unstemmed Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features
title_short Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features
title_sort postnasal drip and nasal endoscopy localization and association with clinical features
topic diagnosis
nasal endoscopy
postnasal drip
reflux
rhinitis
sinusitis
url https://doi.org/10.1002/oto2.70094
work_keys_str_mv AT jenilkumarhpatel postnasaldripandnasalendoscopylocalizationandassociationwithclinicalfeatures
AT nicholasmankowski postnasaldripandnasalendoscopylocalizationandassociationwithclinicalfeatures
AT robbieabeyl postnasaldripandnasalendoscopylocalizationandassociationwithclinicalfeatures
AT manalsmalik postnasaldripandnasalendoscopylocalizationandassociationwithclinicalfeatures
AT andrewparker postnasaldripandnasalendoscopylocalizationandassociationwithclinicalfeatures
AT edwarddmccoul postnasaldripandnasalendoscopylocalizationandassociationwithclinicalfeatures