Practical Reviews

Suspect Postnasal Drip When Cobblestoning Is Present


When attempting to diagnose upper airway cough syndrome (UACS; previously called postnasal drip syndrome), the best history question to ask is as follows. "Do you have frequent throat clearing?" Throat Clearing: Asking patients about the frequency of their throat clearing is very important. In addition, patients can be observed during their clinical visit. If they are clearing their throats frequently, then they probably have postnasal drip. Many of them may not be aware of the feeling of the mucus going down the back of their throat, but it will get onto their vocal cords and they will need to clear their throat a lot. Physical Examination: On physical examination, the physical finding of cobblestoning in the posterior pharynx strongly suggests chronic postnasal drip. Cobblestoning is observed in the posterior pharynx, and it looks like a lot of little cobblestones at the back of the throat. Another sign that may suggest postnasal drip is coating of the posterior third of the tongue more...

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