Managing Post-nasal Drip: Treatment of Sinonasal Disease and Laryngeal Hypersensitivity

PROGRAM DESCRIPTION: Postnasal drip (PND) is one of the most common presenting complaints in otolaryngology and primary care clinics. Symptoms are often non-specific and can include nasal drainage, sensation of mucus, throat clearing, globus pharyngeus, and cough. Initial treatment of PND is usually comprised of intranasal and/or oral antihistamines, topical nasal steroids, and anticholinergics. Mucolytics and acid suppressants are also frequently utilized in the treatment of any underlying endolaryngeal mucus and laryngopharyngeal reflux. Management of these challenging patients after medical treatments fail can be frustrating for both the patient and the clinician. This lecture will include case-based examples that will focus on the treatment of “postnasal drip syndrome” from both the sinonasal and laryngeal standpoint. Available treatment modalities to address chronic allergic/non-allergic rhinitis, posterior nasal nerve hyperfunction and throat clearing/cough related to laryngeal hypersensitivity will be described.

OUTCOME OBJECTIVE 1: Discuss potential etiologies and medical management of postnasal drip from the sinonasal and laryngeal perspectives

OUTCOME OBJECTIVE 2: Review patient selection criteria and techniques for in-office radiofrequency and cryoablation procedures in the treatment of chronic allergic/non-allergic rhinitis and posterior nasal nerve dysregulation

OUTCOME OBJECTIVE 3: Describe treatment options for laryngeal hypersensitivity symptoms including neuromodulators and the superior laryngeal nerve block

BACKGROUND STATEMENT: This expert lecture was presented in 2023 and 2024. The attendance record indicates a strong member interest in this topic.

Comprehensive Otolaryngology Track Statement : Determining the etiology of post nasal drip is a challenge every otolaryngologist faces. Clinicians treating this disorder should be familiar with treatment of both sinonasal pathology and laryngopharyngeal pathology to create a holistic treatment plan.