Injection Augmentation for Chronic Cough.

Area of Science:

• Laryngology
• Otolaryngology
• Speech and Language Pathology

Background:

• Chronic cough (CC) is a widespread and costly health issue in the US.
• Diverse etiologies contribute to CC, necessitating varied therapeutic approaches.
• Vocal fold paresis can exacerbate CC, making standard treatments less effective.

Purpose of the Study:

• To evaluate the efficacy of injection augmentation for CC in patients refractory to medical and behavioral therapies.
• To assess changes in cough severity, reflux, dyspnea, and voice handicap post-injection.

Main Methods:

• Retrospective case review of six patients (1 male, 5 females; ages 24-84) with CC unresponsive to conventional management.
• Vocal fold injection augmentation was performed.
• Pre- and post-injection assessments included Cough Severity Index (CSI), Reflux Symptom Index (RSI), Dyspnea Severity Index (DSI), and Voice Handicap Index-10 (VHI-10), along with subjective evaluations.

Main Results:

• Five out of six patients reported subjective improvement in their cough.
• Significant improvements were observed in CSI scores for all patients (average change 7.3).
• RSI and DSI scores also improved significantly; VHI-10 scores did not change significantly. One patient experienced transient hoarseness, and another required repeat injections due to material resorption.

Conclusions:

• Injection augmentation offers a novel therapeutic option for select patients with chronic cough refractory to prior treatments.
• This intervention can provide relief from chronic cough, serving as an alternative to traditional medical management.