Standardized Behavioral Treatment Improves Chronic Cough

Area of Science:

• Otolaryngology and Speech-Language Pathology
• Neuroscience and Upper Airway Disorders

Background:

• Neurogenic Laryngeal Hypersensitivity (NLH) involves upper airway symptomology attributed to neural pathway disturbances.
• Behavioral therapy shows promise for managing laryngeal motor dysfunction and sensory disturbances.
• Non-pharmacologic interventions are explored for persistent NLH symptoms.

Purpose of the Study:

• To evaluate the efficacy of non-pharmacologic behavioral treatment for Neurogenic Laryngeal Hypersensitivity (NLH).
• To determine if trained speech-language pathologists (SLPs) can achieve significant symptomatic improvement in NLH patients.
• To assess the impact of a standardized behavioral protocol on NLH symptomology.

Main Methods:

• Retrospective review of 81 patients diagnosed with NLH from 2017-2020 at a tertiary care center.
• Inclusion criteria: persistent symptoms despite maximal medical management.
• Newcastle Laryngeal Hypersensitivity Questionnaire (NLHQ) administered pre- and post-therapy; improvement defined by a 1.7-point change.

Main Results:

• Statistically significant improvement in NLHQ scores post-therapy across all patients (P < 0.008).
• Clinically significant improvement observed in 66% of patients.
• Higher rates of improvement seen in patients with initially abnormal NLHQ scores (76%) compared to those with normal scores (14%).

Conclusions:

• A standardized behavioral treatment protocol administered by SLPs is effective for the majority of NLH patients.
• Consistent results can be achieved by SLPs adhering to a standardized protocol.
• Behavioral therapy offers a viable non-pharmacologic approach for managing NLH symptoms.