title: Postnasal drip and chronic cough: An open interventional study.
abstract: 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.
authors.affiliation: Royal Brompton Hospital, Imperial College, London, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Macedo
authors.forename: Hesham
authors.initials: H
authors.lastname: Saleh
authors.forename: Alfonso
authors.initials: A
authors.lastname: Torrego
authors.forename: Justine
authors.initials: J
authors.lastname: Arbery
authors.forename: Ian
authors.initials: I
authors.lastname: MacKay
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Durham
authors.forename: Kian Fan
authors.initials: KF
authors.lastname: Chung
mesh_terms: 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
chemical_list: D000730:Androstadienes; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010793:Phthalazines; D000068298:Fluticasone; C020976:azelastine