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Introduction
The most common chronic diseases of the paranasal sinuses are chronic paranasal sinusitis and fungal sinusitis. Clinically, blood-tinged post-nasal drip is seldom observed in these two disease entities.1 The presence of this symptom might indicate a different diagnosis in patients with paranasal sinus disease. A larger amount of bleeding from paranasal sinus lesions would cause epistaxis, and exploration to investigate a possible sinonasal origin would be performed. However, if the bleeding was mild, blood-tinged post-nasal drip would be present and the differential diagnosis would be more challenging.
Although the presence of blood-tinged post-nasal drip would intuitively prompt suspicion of other sinonasal diseases or malignancies, no previously published study has assessed the significance of this symptom in patients with paranasal sinus disease. The purpose of this study was to analyse the clinical importance of this symptom in these patients.
Materials and methods
A prospective study was performed between August 2000 and April 2005. One hundred and ninety-three patients with paranasal sinus lesions who had undergone endoscopic sinus surgery for treatment or biopsy were recruited. Their ages ranged from seven to 73 years, with an average of 42 years. One hundred and thirty-six patients were male and 57 were female. Information on demographic features, clinical symptoms, computed tomography (CT) scan findings and pathological results were collected. Laterality, bony destruction, calcification and Lund-Mackay scores2 for CT scan images were also documented. In addition to the usual symptoms of sinonasal diseases, a history of blood-tinged post-nasal drip was recorded. The definition of blood-tinged post-nasal drip was that the symptom was reported by patients during history-taking. In addition, patients had to describe the post-nasal drip sensation clearly, and there had to be no coughing or vomiting associated. This explicit definition aimed to exclude confusion with haemoptysis or haematemesis.
The frequency of blood-tinged post-nasal drip was analysed for different diseases. The distributions of diseases with and without blood-tinged post-nasal drip were compared. In addition, statistical interactions between the presence of blood-tinged post-nasal drip and the patient's age and sex were also analysed. We arbitrarily defined two age groups with a cut-off point of 40 years, to enable comparison. Other symptoms of sinusitis were also collected and analysed. In patients with chronic paranasal sinusitis, these analyses were performed separately....