Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement

Nicole M Ryan; Anne E. Vertigan; Peter G. Gibson

doi:10.1186/1745-9974-5-4

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Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement

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Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement

Nicole M Ryan, Anne E. Vertigan and Peter G. Gibson

Cough (London, England), Vol.5, 4

17/03/2009

DOI: https://doi.org/10.1186/1745-9974-5-4

PMID: 19292930

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Abstract

Obstructive sleep apnea

Capsaicin

Chronic cough

Flow volume loop

Cough reflex sensitivity

Rationale Chronic persistent cough can be associated with laryngeal dysfunction that leads to symptoms such as dysphonia, sensory hyperresponsiveness to capsaicin, and motor dysfunction with paradoxical vocal fold movement and variable extrathoracic airflow obstruction (reduced inspiratory airflow). Successful therapy of chronic persistent cough improves symptoms and sensory hyperresponsiveness. The effects of treatment for chronic cough on laryngeal dysfunction are not known. Objective The aim of this study was to investigate effects of therapy for chronic cough and paradoxical vocal fold movement. Methods Adults with chronic cough (n = 24) were assessed before and after treatment for chronic persistent cough by measuring quality of life, extrathoracic airway hyperresponsiveness to hypertonic saline provocation, capsaicin cough reflex hypersensitivity and fibreoptic laryngoscopy to observe paradoxical vocal fold movement. Subjects with chronic cough were classified into those with (n = 14) or without (n = 10) paradoxical vocal fold movement based on direct observation at laryngoscopy. Results Following treatment there was a significant improvement in cough related quality of life and cough reflex sensitivity in both groups. Subjects with chronic cough and paradoxical vocal fold movement also had additional improvements in extrathoracic airway hyperresponsiveness and paradoxical vocal fold movement. The degree of improvement in cough reflex sensitivity correlated with the improvement in extrathoracic airway hyperresponsiveness. Conclusion Laryngeal dysfunction is common in chronic persistent cough, where it is manifest as paradoxical vocal fold movement and extrathoracic airway hyperresponsiveness. Successful treatment for chronic persistent cough leads to improvements in these features of laryngeal dysfunction.

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Title: Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement
Creators: Nicole M Ryan - University of Newcastle Australia
Anne E. Vertigan - University of Newcastle Australia
Peter G. Gibson - University of Newcastle Australia
Publication Details: Cough (London, England), Vol.5, 4
Publisher: BioMed Central
Identifiers: 991013184711402368
Copyright: © 2009 Ryan et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0).
Academic Unit: Faculty of Health
Language: English
Resource Type: Journal article

Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement

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