Takumi Kumai, Kensuke Nishi, Ayaki Tanaka, Hitoshi Hagino, Yoshihiro Ohno, Hiroyuki Takezawa, Akira Sakakibara, Tomoko Shintani, Satsuki Araki, Daigo Komazawa, Manabu Mogitate, Yoshinao Nishida, Noriko Nishiwaki, Ryuzo Toriya, Hirobumi Ito, Toshiyuki Kusuyama, Osamu Hotta, Yasuaki Harabuchi
This multicenter prospective study proposes diagnostic criteria for chronic nasopharyngitis and shows that EAT was associated with improvement in symptoms and endoscopic inflammation. These findings suggest that targeted nasopharyngeal therapy may represent a clinically relevant approach for chronic nasopharyngitis, including cases with systemic symptoms, although controlled studies are required to establish its therapeutic efficacy.
OBJECTIVE: Chronic nasopharyngitis is an under-recognized clinical condition, although the nasopharynx may serve as a source of persistent local and systemic symptoms. This study aimed to define diagnostic criteria for chronic nasopharyngitis and to prospectively evaluate changes in symptoms and endoscopic changes following nasopharyngeal abrasive therapy (EAT).
METHODS: A multicenter prospective observational study. Patients with chronic nasopharyngitis treated between April 2022 and March 2025. Of 219 enrolled patients, 175 were included in the final analysis. EAT was administered weekly for two months using a transnasal or transoral cotton swab soaked in 1% zinc chloride. Nasopharyngeal endoscopic findings were prospectively graded using a three-point scoring system. Symptoms were assessed using a visual analog scale (VAS).
RESULTS: Chronic nasopharyngitis was defined as persistent nasopharyngeal-related local or systemic symptoms lasting longer than one month, refractory to pharmacologic therapy, with endoscopic evidence of nasopharyngeal inflammation. The most common chief complaints were postnasal drip, general fatigue, and globus sensation. Median VAS scores for chief complaints decreased from 90 at baseline to 60 after one month and to 25 after two months. Improvements in endoscopic findings and symptoms were observed across local and systemic manifestations, including in patients with long COVID. Patients with severe nasopharyngitis demonstrated less pronounced symptom improvement.
CONCLUSION: This multicenter prospective study proposes diagnostic criteria for chronic nasopharyngitis and shows that EAT was associated with improvement in symptoms and endoscopic inflammation. These findings suggest that targeted nasopharyngeal therapy may represent a clinically relevant approach for chronic nasopharyngitis, including cases with systemic symptoms, although controlled studies are required to establish its therapeutic efficacy.