Cough and paradoxical vocal fold motion.

Area of Science:

• Otolaryngology
• Pulmonology
• Gastroenterology
• Neurology

Background:

• Chronic cough and disordered breathing present diagnostic challenges for otolaryngologists.
• Common causes like asthma, bronchitis, tracheal stenosis, vocal fold paralysis, neoplasms, allergies, and rhinosinusitis are often treatable.
• Patients refractory to standard medical treatment require consideration of less common etiologies.

Purpose of the Study:

• To review the literature on the differential diagnosis and treatment of chronic cough, paradoxical vocal fold motion, and disordered breathing.
• To explore the complex neurologic mechanisms underlying cough production.
• To examine the relationship between gastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion.

Main Methods:

• A comprehensive review of the current medical literature was conducted.
• The review focused on neurologic mechanisms of cough and associated conditions.
• Literature exploring gastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion was analyzed.

Main Results:

• Diagnosing and treating chronic cough requires understanding neurologic mechanisms of cough.
• Successful treatment involves aggressive management of reactive airway disease, gastroesophageal reflux disease, and paradoxical vocal fold motion.
• A coordinated effort among pulmonologists, otolaryngologists, gastroenterologists, and speech pathologists is often necessary.

Conclusions:

• Gastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion are important considerations for chronic cough and disordered breathing when other causes are absent.
• A high index of suspicion is crucial for diagnosis.
• An effective multidisciplinary treatment plan is essential for these patients.