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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

Log change in Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope (DRS) to hypertonic saline provocation correlated with log change in Cough Reflex Sensitivity (CRS) to capsaicin.
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Figure 3: Log change in Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope (DRS) to hypertonic saline provocation correlated with log change in Cough Reflex Sensitivity (CRS) to capsaicin.

Mentions: There was a moderately significant (r = -0.65, p = 0.02) correlation in the Cough+PVFM Group for treatment related changes in extrathoracic airway hyperresponsiveness dose response slope and CRS-C5 [Figure 3]. This decrease in cough sensitivity corresponding with a fall in extrathoracic airway hyperresponsiveness dose response slope further supports validity of PVFM treatment with speech language therapy compared to no correlation between these two measures for the CC Group who did not undertake speech language therapy.


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

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

Log change in Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope (DRS) to hypertonic saline provocation correlated with log change in Cough Reflex Sensitivity (CRS) to capsaicin.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Log change in Extrathoracic Airway Hyperresponsiveness (EAHR) represented as FIF50 Dose Response Slope (DRS) to hypertonic saline provocation correlated with log change in Cough Reflex Sensitivity (CRS) to capsaicin.
Mentions: There was a moderately significant (r = -0.65, p = 0.02) correlation in the Cough+PVFM Group for treatment related changes in extrathoracic airway hyperresponsiveness dose response slope and CRS-C5 [Figure 3]. This decrease in cough sensitivity corresponding with a fall in extrathoracic airway hyperresponsiveness dose response slope further supports validity of PVFM treatment with speech language therapy compared to no correlation between these two measures for the CC Group who did not undertake speech language therapy.

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