Cough and paradoxical vocal fold motion

Kenneth W. Altman, C. Blake Simpson, Milan R. Amin, Mona Abaza, Ron Balkissoon, Roy R Casiano

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

OBJECTIVES: The differential diagnosis and treatment of patients with chronic cough, paradoxical vocal fold motion, and disordered breathing can be a challenge to most practicing otolaryngologists. Tracheobronchial (ie, asthma, bronchitis, and tracheal stenosis), laryngeal (ie, vocal fold paralysis and neoplasms), and rhinologic (ie, allergies and rhinosinusitis) etiologies are commonly diagnosed and treated effectively. However, occasionally one is faced with patients who are refractory to medical treatment and have no obvious rhinologic, laryngeal or pulmonary cause. STUDY DESIGN AND SETTING: We conducted a review of the literature. METHODS: We present a thorough review of the current medical literature exploring the complex neurologic mechanisms involved in the production of cough and the relationship between gastroesophageal reflux disease, vagal neurapathy, and paradoxical vocal fold motion. RESULTS: The diagnosis and successful treatment of chronic cough can be complex. It requires a thorough understanding of the neurologic mechanisms behind cough excitation and suppression. Successful treatment strategies include aggressive management of the patient's reactive airway disease, gastroesophageal reflux disease, and, in select cases, paradoxical vocal fold motion. This may involve a well-coordinated effort among pulmonologists, otolaryngologists, gastroenterologists, and speech pathologists. CONCLUSION: Gastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion are additional causes of chronic cough and disordered breathing that need to be considered, in the absence of obvious laryngotracheal and/or rhinologic pathology. A high index of suspicion is essential in making the diagnosis and formulating an effective multidisciplinary treatment plan for these patients.

Original languageEnglish
Pages (from-to)501-511
Number of pages11
JournalOtolaryngology - Head and Neck Surgery
Volume127
Issue number6
DOIs
StatePublished - Dec 1 2002

Fingerprint

Vocal Cord Dysfunction
Cough
Gastroesophageal Reflux
Nervous System
Respiration
Tracheal Stenosis
Therapeutics
Bronchitis
Vocal Cords
Paralysis
Hypersensitivity
Differential Diagnosis
Asthma
Pathology
Lung
Neoplasms

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Altman, K. W., Simpson, C. B., Amin, M. R., Abaza, M., Balkissoon, R., & Casiano, R. R. (2002). Cough and paradoxical vocal fold motion. Otolaryngology - Head and Neck Surgery, 127(6), 501-511. https://doi.org/10.1067/mhn.2002.127589

Cough and paradoxical vocal fold motion. / Altman, Kenneth W.; Simpson, C. Blake; Amin, Milan R.; Abaza, Mona; Balkissoon, Ron; Casiano, Roy R.

In: Otolaryngology - Head and Neck Surgery, Vol. 127, No. 6, 01.12.2002, p. 501-511.

Research output: Contribution to journalArticle

Altman, KW, Simpson, CB, Amin, MR, Abaza, M, Balkissoon, R & Casiano, RR 2002, 'Cough and paradoxical vocal fold motion', Otolaryngology - Head and Neck Surgery, vol. 127, no. 6, pp. 501-511. https://doi.org/10.1067/mhn.2002.127589
Altman KW, Simpson CB, Amin MR, Abaza M, Balkissoon R, Casiano RR. Cough and paradoxical vocal fold motion. Otolaryngology - Head and Neck Surgery. 2002 Dec 1;127(6):501-511. https://doi.org/10.1067/mhn.2002.127589
Altman, Kenneth W. ; Simpson, C. Blake ; Amin, Milan R. ; Abaza, Mona ; Balkissoon, Ron ; Casiano, Roy R. / Cough and paradoxical vocal fold motion. In: Otolaryngology - Head and Neck Surgery. 2002 ; Vol. 127, No. 6. pp. 501-511.
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