Laryngeal Lesions in Patients with Chronic Cough and Normal Chest Radiographs and Auscultation

Abstract 

Objectives

Chronic cough, defined as a cough persisting for more than 8 weeks, is a common chief complaint in the outpatient department. The role of laryngeal lesions in these patients is discussed in this paper.

Materials and Methods

Seventy-seven patients (29 men, 48 women) were enrolled retrospectively at my clinics in one regional hospital and two local hospitals located in Taoyuan county and in Hsinchu county, from January to June, 2006. Their ages ranged from 19 to 83 years (mean, 52.7 years). The duration of symptoms was from 8 weeks to over 2 decades (70.1% of the patients: = 3 years). Before examination with a flexible fiberoptic nasopharyngoscope, obvious bronchopulmonary disease had been ruled out using chest radiography and chest auscultation.

Results

Of the patients examined, 61.0% had laryngeal lesions, including vocal fold atrophy (61.7%), vocal fold sulcus (19.1%), vocal nodules (14.9%), vocal polyps (8.5%), vocal corditis (4.3%), unilateral vocal cord palsy (2.1%), and laryngeal neoplasm (2.1%). Of the patients with laryngeal lesions, 48.9% complained of hoarseness. Among patients with hoarseness, 88.5% had laryngeal lesions. There was a statistically significant difference in the presence of hoarseness between patients with and without laryngeal lesions (p < 0.05, χ² test). Patients without laryngeal lesions had a higher cure rate for chronic cough than patients with these lesions (p < 0.05, χ² test) after 10 patients who were lost to follow-up were excluded.

Conclusion

Both the larynx and its dynamics should be evaluated together when a patient presents with chronic cough because laryngeal lesions are comitant. In addition, laryngeal malignancy needs early diagnosis and early treatment.

Keywords:  Chronic cough , Flexible fiberoptic nasopharyngoscope , Laryngeal lesion

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