case_images: PMC9815934_01
case_images: Effect of Epipharyngeal abrasive therapy (EAT) in the patient.. Upper panels show endoscopic characteristics before EAT at the first visit and 1, 2, and 3 months. The white triangle indicates swelling of the epipharyngeal mucosa. The white arrow indicates mucus adhesion. Lower panels show bleeding induced by EAT at the first visit and 1, 2, and 3 months. The black arrow indicates a sterile nasal cotton swab containing zinc chloride.
case_images: cureus-0015-00000033421-i01.jpg
case_images: PMC9815934_01_cureus-0015-00000033421-i01.jpg
case_images: FIG1
case_images: Epipharyngeal endoscopic examination showed marked epipharyngeal swelling and a postnasal drip (Figure 1).
case_images: Expression patterns of interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), and SARS-CoV-2 mRNAs in the epipharynx in the patient.. Expression patterns of IL-6 and TNF-alpha, and SARS-CoV-2 mRNAs (brown dots) in the epipharynx (Upper panels) at the first visit and (Lower panels) at three months. Magnified images are shown in each lower panel. RNA scope (in situ hybridization system, Advanced Cell Diagnostics, Hayward, CA, USA; IL-6: No. 310371, TNF-alpha: No. 310421, and SARS-CoV-2: No. 848561) was used following the manufacturer's guidelines.
case_images: cureus-0015-00000033421-i02.jpg
case_images: PMC9815934_01_cureus-0015-00000033421-i02.jpg
case_images: FIG2
case_images: Additionally, in situ hybridization revealed residual severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike RNA in the epipharynx (Figure 2). Additionally, SARS-CoV-2 spike RNA persistence was confirmed before treatment had disappeared (Figure 2).
case_images: Improvement of epipharyngeal inflammation and cough by Epipharyngeal abrasive therapy (EAT). . The inflammation of chronic epipharyngitis was scored by the Japan Society of Stomato-pharyngology EAT Review Committee's assessment criteria for 1) Redness of the epipharyngeal mucosa, 2) swelling of the epipharyngeal mucosa, 3) mucus or crust adhesion, and 4) bleeding during abrasion. Each was rated on a three-point scale (0: none; 1: mild-moderate; 2: severe). The visual analog scale (VAS) for coughing was scored from 0 (absence of symptoms) to 10 (highest severity of symptoms).
case_images: cureus-0015-00000033421-i03.jpg
case_images: PMC9815934_01_cureus-0015-00000033421-i03.jpg
case_images: FIG3
case_images: His epipharyngeal inflammation had improved (Figure 3) and the chronic sinusitis had also improved (modified Lund-Mackay score: 21/54 3/54). The visual analog scale (VAS) score for coughing improved from 7.0 to 0.2 (Figure 3).