| All 3 of the following criteria must be met |
|---|
| (1) Symptoms suggestive of chronic epipharyngitis that do not improve with any medical treatment persist for at least one month |
| (2) No organic disease of the nasal cavity, paranasal sinuses, oropharynx, hypopharynx, or larynx |
| (3) Endoscopic evidence of inflammation in the epipharynx such as redness, swelling of the mucous membrane and adhesion/postnasal drip of epipharyngeal-derived mucus, in addition to bleeding due to epipharyngeal abrasion |
| Local symptoms due to inflammation of the epipharynx | Functional somatic symptoms due to hypothalamus-limbic system dysfunction through disturbances of vagal response and cerebrospinal fluid outflow | Distant organ symptoms caused by the epipharynx lymphatic tissue as an etiologic organ | |||
|---|---|---|---|---|---|
| Stiff shoulders/stiff neck | 89 | Chronic fatigue | 86 | Sternocostal joint pain | 4 |
| Postnasal drip | 72 | Dizzy sensation | 46 | Psoriasis | 1 |
| Pharyngeal discomfort | 72 | Insomnia | 10 | Chronic urticaria | 1 |
| Headache | 63 | Brain fog | 10 | ||
| Sore throat | 46 | Difficulty breathing | 9 | ||
| Chronic cough | 39 | Photophobia | 6 | ||
| Voice disorder | 39 | Lower back pain/back pain | 3 | ||
| Olfaction/Taste disorder | 8 | Palpitations | 4 | ||
| Nasal congestion | 6 | Slight fever | 2 | ||
| Tinnitus/Ear congestion | 5 | Restless legs | 2 | ||
| Chronic phlegm | 5 | Tongue pain | 2 | ||
| Facial discomfort | 3 | Nausea | 2 | ||
| Toothache | 1 | Whole body neuralgia | 2 | ||
| Nose pain | 1 | Anxiety disorder | 1 | ||
| Snoring | 1 | Numbness in limbs | 1 | ||
| Pain behind the eyes | 1 | Diarrhea/Constipation | 1 | ||
| Gastrointestinal disorders | 1 | ||||
| Hot flashes | 1 | ||||
| Chest pain | 1 | ||||
| Appetite loss | 1 | ||||
