Cough and paradoxical vocal fold motion

被引:68
作者
Altman, KW
Simpson, CB
Amin, MR
Abaza, M
Balkissoon, R
Casiano, RR
机构
[1] Univ Miami, Hosp & Clin, Dept Otolaryngol, Miami, FL 33136 USA
[2] Northwestern Univ, Dept Otolaryngol, Sch Med, Chicago, IL 60611 USA
[3] Univ Texas, Med Ctr, Dept Otolaryngol, San Antonio, TX 78285 USA
[4] Ahanemann Univ, Med Coll Philadelphia, Dept Otolaryngol, Philadelphia, PA USA
[5] Univ Colorado, Sch Med, Dept Otolaryngol, Denver, CO 80202 USA
[6] Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA
[7] Univ Colorado, Hlth Sci Ctr, Dept Biometr & Prevent Med, Denver, CO 80262 USA
关键词
D O I
10.1067/mhn.2002.127589
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
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 (le, 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.
引用
收藏
页码:501 / 511
页数:11
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