Two holes syndrome (THS) is present in more than half of the postnasal drip patients?

Conclusion: Posterior fontanelle defects were found in almost half of the patients with postnasal drip and in a negligible number in the cohort of healthy subjects. Objectives: The aim of this study was to compare the incidence of fontanelle defects in patients with postnasal drip and in healthy subjects. Materials: A total of 723 outpatients suffering from postnasal drip as a leading symptom were examined during the last 10 years by means of nasal fiberendoscopy. The authors were searching for defects in the posterior fontanelle region and recirculating mucus. The control group consisted of 312 healthy volunteers with no history of postnasal drip. Results: The defect in the posterior fontanelle was found in 414 of 723 patients with postnasal drip (57.3%). It was bilateral in 238 of 414 cases (57.5%). The defect in the anterior fontanelle was not found in this cohort at all. The recirculating mucus ring was clearly identified in 107 of 414 patients (25.8%). The defect in the posterior fontanelle was found in only 7 of 312 healthy volunteers (2.2%) (p < 0.01).