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

Ryan NM, Vertigan AE, Gibson PG - Cough (2009)

Bottom Line: 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).Subjects with chronic cough and paradoxical vocal fold movement also had additional improvements in extrathoracic airway hyperresponsiveness and paradoxical vocal fold movement.Laryngeal dysfunction is common in chronic persistent cough, where it is manifest as paradoxical vocal fold movement and extrathoracic airway hyperresponsiveness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, Newcastle, 2308, NSW, Australia. Nicole.Ryan@newcastle.edu.au

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

a Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough with paradoxical vocal fold movement (CC+PVFM) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.02. b Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough alone (CC) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.58.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2664779&req=5

Figure 2: a Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough with paradoxical vocal fold movement (CC+PVFM) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.02. b Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough alone (CC) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.58.

Mentions: Twenty-four subjects with a chronic persistent cough participated in the study. The subjects had a median (IQR) cough duration of 24 (13–84) months and were predominantly female [Table 1]. There were 14 subjects with Cough+PVFM and 10 with Cough alone (CC). Subjects were treated [Table 2] and both groups responded with a significant improvement in cough-related quality of life (LCQ, p = 0.001 for Cough+PVFM Group, p = 0.01 for CC Group), associated diagnosis symptom questionnaire scores [Table 3] and cough reflex sensitivity (C5, p = 0.008 for Cough +PVFM Group and C5, p = 0.04 for CC Group), [Figures 1a, 1b]. For the Cough+PVFM subjects, we found that PVFM and extrathoracic airway hyperresponsiveness responded positively to treatment and was significantly reduced for the Cough+PVFM group, [Figure 2a] and unchanged for the CC alone group, [Figure 2b].


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

Ryan NM, Vertigan AE, Gibson PG - Cough (2009)

a Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough with paradoxical vocal fold movement (CC+PVFM) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.02. b Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough alone (CC) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.58.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2664779&req=5

Figure 2: a Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough with paradoxical vocal fold movement (CC+PVFM) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.02. b Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope to hypertonic saline provocation before (pre) and after (post) treatment in the chronic cough alone (CC) group. Solid bars are median values, with median (IQR) reported on figure, p = 0.58.
Mentions: Twenty-four subjects with a chronic persistent cough participated in the study. The subjects had a median (IQR) cough duration of 24 (13–84) months and were predominantly female [Table 1]. There were 14 subjects with Cough+PVFM and 10 with Cough alone (CC). Subjects were treated [Table 2] and both groups responded with a significant improvement in cough-related quality of life (LCQ, p = 0.001 for Cough+PVFM Group, p = 0.01 for CC Group), associated diagnosis symptom questionnaire scores [Table 3] and cough reflex sensitivity (C5, p = 0.008 for Cough +PVFM Group and C5, p = 0.04 for CC Group), [Figures 1a, 1b]. For the Cough+PVFM subjects, we found that PVFM and extrathoracic airway hyperresponsiveness responded positively to treatment and was significantly reduced for the Cough+PVFM group, [Figure 2a] and unchanged for the CC alone group, [Figure 2b].

Bottom Line: 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).Subjects with chronic cough and paradoxical vocal fold movement also had additional improvements in extrathoracic airway hyperresponsiveness and paradoxical vocal fold movement.Laryngeal dysfunction is common in chronic persistent cough, where it is manifest as paradoxical vocal fold movement and extrathoracic airway hyperresponsiveness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, Newcastle, 2308, NSW, Australia. Nicole.Ryan@newcastle.edu.au

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus