Postnasal drip and chronic cough: An open interventional study.
BACKGROUND
The postnasal drip (PND) syndrome is often linked as a cause of chronic cough although this is disputed.


OBJECTIVE
We examined the effect of specific topical treatment of rhinosinusitis on cough in patients presenting with a chronic cough associated with a postnasal drip or 'nasal catarrh'.


METHODS
Patients presenting with a chronic cough and who complained of PND were enrolled and symptoms of PND and cough were assessed by questionnaire and by a capsaicin cough response. Rhinosinusitis was assessed by questionnaires, direct examination of the nose and by high-resolution computed tomography. In an open study, they were treated with fluticasone nasules, ipratropium bromide and azelastine nasal sprays for 28 days, after which they were re-assessed.


RESULTS
Eighteen out of 21 patients completed the study. All patients reported having the presence of mucus in the throat. Mean cough score improved post-treatment (p<0.05), but there was no significant change in capsaicin cough sensitivity or nasal catarrh questionnaire score. There was improvement in anterior nasal discharge symptom scores (p=0.005) and in endoscopic nasal scores post-treatment (p<0.01), with a tendency to improved PND scores.


CONCLUSIONS
In a pilot open 'real-life' study treatment targeted towards rhinosinusitis accompanying PND syndrome and chronic cough led to an improvement in cough. A randomised controlled study is now needed to confirm or refute these findings.
Macedo
Patricia
P
Royal Brompton Hospital, Imperial College, London, UK.
Saleh
Hesham
H
Torrego
Alfonso
A
Arbery
Justine
J
MacKay
Ian
I
Durham
Stephen R
SR
Chung
Kian Fan
KF
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002908:Chronic Disease; D003371:Cough / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism*; D010793:Phthalazines / Q000008:administration & dosage; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D012852:Sinusitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011795:Surveys and Questionnaires; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D000730:Androstadienes; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010793:Phthalazines; D000068298:Fluticasone; C020976:azelastine