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Hyun Kuk Kim, M.D.1, Eun Young Choi, M.D.2, Jae Seung Lee, M.D.2, Yun Jeong Bae, M.D.3, Jin Woo Song, M.D.2, 4, Tae-Bum Kim, M.D.3, 4, You Sook Cho, M.D.3, 4
, Hee-Bom Moon, M.D.3, 4, Sang Do Lee, M.D.2, 4, Yeon-Mok Oh, M.D.2, 4
, Hee-Bom Moon, M.D.3, 4, Sang Do Lee, M.D.2, 4, Yeon-Mok Oh, M.D.2, 4
Abstract
Background
Rhinolaryngoscopy and sputum examination are popular tests for the evaluation of chronic cough. Little is known about the relationship between symptoms and rhinolaryngoscopic findings or sputum eosinophilia in chronic cough patients.
Methods
One hundred patients, who had chronic cough with normal chest radiography and who also had undergone both rhinolaryngoscopy and induced sputum analysis, were reviewed retrospectively. Eleven associated symptoms of chronic cough were asked; postnasal drip (PND) and laryngopharyngeal reflux (LPR) were examined by rhinolaryngoscopy. Induced sputum analysis was performed for evaluation of sputum eosinophilia. Cross tabulation analyses with chi-square tests were used to evaluate the relationship between symptoms and objective findings.
Results
The most frequent symptom was sputum (70%). The prevalence of PND and LPR on rhinolaryngoscopy were 56% (56/100) and 25.6% (22/86), respectively. Sputum eosinophilia was observed in 23 (23.7%) of 97 patients. The dyspnea (p=0.001), sputum (p=0.003), nasal obstruction (p=0.023), and postnasal drip sense (p=0.025) were related with PND on rhinolaryngoscopy. LPR on rhinolaryngoscopy was not related with any symptoms. Dyspnea (p=0.003), wheezing (p=0.005), nasal obstruction (p=0.013), and belching (p=0.018) were related with sputum eosinophilia.
Figures and Tables
Figure 1
Endoscopes for the evaluation of nasal cavity, pharynx and larynx. The upper endoscope has 70° angle at the tip and was used to examine the oropharynx and larynx. The lower one was used to examine the inside of the nasal cavity and nasopharyngeal mucosa.
Figure 2
Percentage of patients with each symptom among all of the chronic cough patients. PND: postnasal drip.
Figure 3
Percentage of patients with positive findings in rhinolaryngoscopy and induced sputum among all of the chronic cough patients. PND: postnasal drip on rhinolaryngoscopy; LPR: laryngopharyngeal reflux on rhinolaryngoscopy.
Figure 4
The comparison of frequency of symptoms according as whether postnasal drip (PND) existed on rhinolaryngoscopy. *p-value <0.05, †p-value <0.01.
Figure 5
The comparison of frequency of symptoms between laryngopharyngeal reflux (LPR) negative and LPR positive patients on rhinolaryngoscopy. PND: postnasal drip.
Figure 6
The comparison of frequency of symptoms depending on the existence of sputum eosinophilia. PND: postnasal drip. *p-value <0.05, †p-value <0.01.
Acknowledgements
This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A040153).
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