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Standardized Behavioral Treatment Improves Chronic Cough.

Eleni A Varelas1, Chaewon Hwang2, Sarah Brown1

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Behavioral therapy effectively treats Neurogenic Laryngeal Hypersensitivity (NLH) symptoms. Trained speech-language pathologists (SLPs) using a standardized protocol significantly improved patient outcomes, demonstrating the therapy

Keywords:
Chronic coughNeurogenic laryngeal hypersensitivityNewcastle laryngeal hypersensitivity questionnaireSpeech language pathologySpeech therapy

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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.