The recalcitrant postnasal-drip syndrome: The great challenge for the allergist-immunologist

Although increased retropharyngeal mucus secretion (postnasal-drip syndrome) is commonly seen in allergic rhinitis, its clinical management has not been fully established. Three parallel investigations were conducted for a period of 4 weeks. 20 patients were treated with topical intranasal corticosteroid Mometasone Furoate (MF) 100 mcg/nostril once daily (group A), 20 patients were treated with topical intranasal antihistamine Olopatadine (OLO) 1330 mcg/nostril twice daily (group B), and 20 patients were treated with the combination of the two pharmacologic agents intranasal Mometasone Furoate (MF) and intranasal Olopatadine (OLO)(group C). The efficacy of the treatment in the three different groups was monitored by rhinomanometry, flexible rhinoscopy and subjective symptom scoring system. The severity and duration of the postnasal-drip decreased in 10/20 (50%) of group A patients (MF), in 7/20 (35%) of group B patients (OLO) and in 16/20 (80%) of group C patients (MF and OLO). Thus although , intranasal Mometasone Furoate or intranasal Olopatadine used individually showed therapeutic benefit, the combined use of nasal Mometasone and nasal Olopatadine led to more significant resolution of the postnasal-drip syndrome due to the possible synergistic effect of the combination drug regimen.