Upper Airway Causes of Chronic Cough

2005 ◽  
pp. 363-374
Keyword(s):  
Chronic Cough ◽  
Upper Airway

Effect of intranasal steroids on chronic cough caused by upper airway cough syndrome

2014 ◽  
Vol 2 (5) ◽  
pp. 362
Author(s):  
Gun-Wung Na ◽  
Dong-Gyu Lee ◽  
Jun-Young Kim ◽  
Won-Il Park ◽  
Kyung-Been Lee ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Intranasal Steroids

scholarly journals Upper Airway Cough Syndrome in Pathogenesis of Chronic Cough

2020 ◽  
pp. S35-S42
Author(s):  
M. Lucanska ◽  
A. Hajtman ◽  
V. Calkovsky ◽  
P. Kunc ◽  
R. Pecova
Keyword(s):  
Chronic Cough ◽  
Sensory Nerve ◽  
Upper Airway ◽  
Vagal Afferents ◽  
Upper Airways ◽  
Cough Reflex ◽  
Postnasal Drip ◽  
Common Causes ◽  
Lower Airways ◽  
Human Airways

Cough is one of the most important defensive reflexes. However, extensive non- productive cough is a harmful mechanism leading to the damage of human airways. Cough is initiated by activation of vagal afferents in the airways. The site of their convergence is particularly the nucleus of the solitary tract (nTS). The second-order neurons terminate in the pons, medulla and spinal cord and there is also the cortical and subcortical control of coughing. Upper airway cough syndrome (UACS) – previously postnasal drip syndrome - is one of the most common causes of chronic cough together with asthma and gastroesophageal reflux. The main mechanisms leading to cough in patients with nasal and sinus diseases are postnasal drip, direct irritation of nasal mucosa, inflammation in the lower airways, upper airway inflammation and the cough reflex sensitization. The cough demonstrated by UACS patients is probably due to hypersensitivity of the upper airways sensory nerve or lower airways sensory nerve, or a combination of both. Further studies are needed to clarify this mechanism.

Do combined upper airway cultures identify lower airway infections in children with chronic cough?

2019 ◽  
Vol 54 (6) ◽  
pp. 907-913 ◽  
Author(s):  
Kim M. Hare ◽  
Anne B. Chang ◽  
Heidi C. Smith‐Vaughan ◽  
Paul A. Bauert ◽  
Brian Spain ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Lower Airway ◽  
Airway Infections

Lund–Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients

2019 ◽  
Vol 33 (3) ◽  
pp. 294-301 ◽  
Author(s):  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Takaya Higaki ◽  
Tomoyasu Tachibana ◽  
Toru Rikimaru ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Function ◽  
Pulmonary Function ◽  
Paranasal Sinus ◽  
Chronic Cough ◽  
Eosinophil Count ◽  
Upper Airway ◽  
Peripheral Blood Eosinophil ◽  
X Ray ◽  
Chest X Ray

Background A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined. Objective The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities. Methods A total of 1412 patients with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund–Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples were examined. The Sino-Nasal Outcome Test was used to determine the severity of clinical symptoms. Results The patients with an abnormal soft tissue shadow in the paranasal sinus had significant obstructive lung function. The percent predicted forced expiratory volume in 1 second (FEV1.0) and the FEV1.0/forced vital capacity ratio negatively correlated with Lund–Mackay CT scores both before and after bronchodilator inhalation. There was a statistically significant correlation between pulmonary function and eosinophil count. Conclusion The patients with chronic cough frequently had paranasal sinus abnormalities. The Lund–Mackay CT score may be useful for assessing the condition of the lower airway in chronic cough patients. Upper airway examinations should play a part in the management of chronic cough.

A review of voice and upper airway function in chronic cough and paradoxical vocal cord movement

2007 ◽  
Vol 7 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Anne E Vertigan ◽  
Peter G Gibson ◽  
Deborah G Theodoros ◽  
Alison L Winkworth
Keyword(s):  
Vocal Cord ◽  
Chronic Cough ◽  
Upper Airway ◽  
Airway Function ◽  
Paradoxical Vocal Cord Movement

Chronic cough in children

2021 ◽  
pp. 175573802110033
Author(s):  
Katie Scott
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Oesophageal Reflux ◽  
British Thoracic Society ◽  
Cough Reflex ◽  
Anatomy And Physiology ◽  
Airway Anatomy ◽  
Common Causes ◽  
Reflex Control

A chronic cough in children is defined in the British Thoracic Society guidelines as a cough of 8 weeks or more. The aetiology of a chronic cough in children differs from adult populations, due to decreased cough reflex control in children, differences in airway anatomy and physiology, and immunological and neurological maturation changes. The three most common causes of chronic cough in adults (asthma, gastro-oesophageal reflux, and upper airway cough syndrome) account for less than 10% of the causes in children. Thus, it is important to assess and manage chronic cough in children differently.

scholarly journals Is Laryngeal Hypersensitivity the Basis for Unexplained or Refractory Chronic Cough?

2021 ◽  
pp. 00793-2020
Author(s):  
Krishna M. Sundar ◽  
Amanda Carole Stark ◽  
Nan Hu ◽  
Julie Barkmeier-Kraemer
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Speech Language Pathology ◽  
Appropriate Treatment ◽  
Leicester Cough Questionnaire ◽  
Language Pathology ◽  
History Of ◽  
Common Problems ◽  
Over 40 Years

BackgroundRefractory chronic cough (RCC) and unexplained chronic cough (UCC) are common problems seen in primary care and subspecialty clinics. The role of cough hypersensitivity and laryngeal dysfunction in contributing to the persistence of cough in RCC/UCC is not well recognised.MethodsData of patients with RCC and UCC evaluated in 2019 by an interdisciplinary cough clinic led by a pulmonologist and speech-language pathology team was reviewed. Patients completed validated questionnaires including the Leicester cough questionnaire (LCQ), voice handicap index (VHI) and dyspnea index questionnaire (DI) at initial encounter. Presence of cough hypersensitivity was based upon a history of allotussia and hypertussia. Laryngeal dysfunction was diagnosed in those with a history of laryngeal paresthesias, throat clearing, voice abnormalities, upper airway dyspnoea and documentation of functional or anatomic laryngeal abnormalities on nasoendoscopy.FindingsOf the 60 UCC/RCC patients analysed, 75% of patients were female and 85% were over 40 years of age. Cough hypersensitivity was documented in all patients and multiple cough triggers occurred in 75% of patients. 95%, 50% and 25% of patients reported laryngeal paresthesias, voice abnormalities and upper airway dyspnoea, respectively. Significant associations between LCQ and VHI and DI scores occurred when adjusting for age, gender, ethnicity and body mass index. Laryngeal functional abnormalities were documented on 44/60 patients on nasoendoscopy.InterpretationHypertussia, allotussia and laryngeal dysfunction are common in patients with RCC and UCC. Evaluation of UCC and RCC can delineate laryngeal hypersensitivity and allows appropriate treatment to be directed at this phenotype.

scholarly journals Diagnosis and management of chronic cough: similarities and differences between children and adults

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 757
Author(s):  
Miles Weinberger ◽  
Manju Hurvitz
Keyword(s):  
Chronic Cough ◽  
Fiberoptic Bronchoscopy ◽  
Upper Airway ◽  
Speech Pathology ◽  
Behavioral Management ◽  
Specific Diagnosis ◽  
Flexible Fiberoptic Bronchoscopy ◽  
Protracted Bacterial Bronchitis ◽  
Habit Cough ◽  
Modest Effect

Cough is a natural process that protects the airway. Cough can occur spontaneously or voluntarily. It is considered chronic when it is present for longer than 4 weeks in children or 8 weeks in adults. In both, chronic cough causes patient distress and increased healthcare utilization. Etiologies of pediatric chronic cough include asthma, protracted bacterial bronchitis, tracheomalacia, habit cough, and various systemic disorders. While some diagnoses are identifiable by careful history alone, others require testing guided by specific pointers. Flexible fiberoptic bronchoscopy has been an important tool to identify etiologies of chronic cough that were not otherwise apparent. In adults, asthma and bronchitis are well-defined etiologies of chronic cough, but much chronic cough in adults is largely a conundrum. Reviews of adult chronic cough report that at least 40% of adults with chronic cough have no medical explanation. Gastroesophageal reflux and upper airway cough syndrome (a.k.a. post-nasal drip) have been common diagnoses of chronic cough, but those diagnoses have no support from controlled clinical trials and have been subjected to multiple published critiques. Cough hypersensitivity is considered to be an explanation for chronic cough in adults who have no other confirmed diagnosis. Gabapentin, a neuromodulator, has been associated with a modest effect in adults, as has speech pathology. While habit cough has not generally been a diagnosis in adults, there is evidence for a behavioral component in adults with chronic cough. Treatment for a specific diagnosis provides a better outcome than trials of cough suppression in the absence of a specific diagnosis. More data are needed for chronic cough in adults to examine the hypothesized cough hypersensitivity and behavioral management. This article reviews etiologies and the treatment of chronic cough in children and the conundrum of diagnosing and treating chronic cough in adults.

scholarly journals Upper airway cough syndrome may be the main cause of chronic cough in Japan: a cohort study

2021 ◽  
Author(s):  
Kimihiko Yasuda
Keyword(s):  
Chronic Cough ◽  
Standard Treatment ◽  
Upper Airway ◽  
Final Diagnosis ◽  
Multivariate Logistic Regression ◽  
Common Cause ◽  
Nasal Steroids ◽  
Potential Use ◽  
Post Infectious ◽  
Observation Period

Abstract BackgroundUpper airway cough syndrome (UACS) is generally considered a common cause of chronic cough but remains poorly recognised in Japan.ObjectiveThis study aimed to assess whether UACS was a common cause of chronic cough in Japan, as is true in other countries. Interview and examination items were evaluated for their potential use in UACS diagnosis.Methods All patients with chronic cough were preliminarily diagnosed with bronchial asthma, UACS, gastroesophageal reflux disease, or post-infectious prolonged cough, based on interviews and examinations. Treatment centred on nasal steroids was administered to the UACS group and standard treatment to the other groups. The observation period lasted 4 weeks. The subjective cough score at first diagnosis was set at 10, and the final diagnosis was made based on the treatment administered at the time the cough score had decreased to ≤ 2. The associations between the presence or absence of UACS and interview and examination items were statistically evaluated.Results Among 230 patients with chronic cough, 146 were diagnosed with UACS-only. Multivariate logistic regression revealed that the assessment items ‘awareness of mucus accumulating in the back of the throat’, ‘presence of abnormal echography findings’, ‘absence of associated coughing when exercising’ and ‘presence of coughing persisting after onset’ were significantly correlated with the presence or absence of UACS (p < 0.05).ConclusionsUACS may be the most common cause of chronic cough in Japan and may be effectively treated with nasal corticosteroids. Diagnosing UACS might be possible by selecting appropriate interview and examination items.

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