Otolaryngology Aspects of Chronic Cough

Abstract

Cough is an increasingly important public health concern, and diagnosis and treatment can be challenging in these complex patients. The purpose of this review is to address the roles of otolaryngology in understanding pathophysiology, and unique aspects in their diagnosis and management. Evidence-based best practice through clinical practice guidelines for cough is emphasized. A step-wise description of the interrelated pathophysiology is used to gain a deeper understanding of contributing disease states and the importance of synergistic effects on cough. Unique perspectives exist from an otolaryngology perspective regarding chronic cough. Included here are the premier role of the larynx, immunity, and the microbiome in the Unified Airway, the interconnected nature of reflux disease with respiratory physiology, a spectrum of neurologic diseases tying aspiration to cough, and maladaptive neuro-based behaviors. Otolaryngology aspects of chronic cough encompass the composite nature of the disease with all of its contributions.

Keywords: Allergy; Cough; Esophageal reflux; Larynx; Otolaryngology; Respiratory disease; Unified Airway.