Laryngeal Lesions in Patients with Chronic Cough and Normal Chest Radiographs and Auscultation
Article Outline
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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References
- The diagnosis and management of chronic cough . Eur Respir J . 2004;24:481–492
- . Postnasal drip causes cough and is associated with reversible upper airway obstruction . Chest . 1984;85:346–352
- . An office approach to the diagnosis of chronic cough . Am Fam Physician . 1998;58:2015–2022
- . The role of sinus imaging in the treatment of chronic cough in adults . Chest . 1999;116:1287–1291
- . Fiberoptic bronchoscopy for refractory cough . Chest . 1991;99:33–35
- . Upper airway anatomy and function . In: Bailey BJ editors. Head & Neck Surgery–Otolaryngology . 3rd edition. Philadelphia: Lippincott Williams & Wilkins; 2001;p. 479–487
- . Removal of laryngopharyngeal foreign bodies under flexible videolaryngoscopy . J Taiwan Otolaryngol Head Neck Surg . 2001;36:277–281
- . Kinelaryngoscopy for documentation of laryngeal pathophysiology . Laryngoscope . 1984;94:58–62
- . Acute superior laryngeal nerve palsy: analysis of 78 cases . Otolaryngol Head Neck Surg . 1980;88:418–424
- . The “silent cough” method for vocal hyperfunction . J Speech Hear Disord . 1973;38:119–125
- . Chronic cough: in search of the etiology . Semin Speech Lang . 1998;19:83–91
- . Eversion of the laryngeal ventricle . Arch Otolaryngol . 1975;101:37–38
- . Muscle tension dysphonia as a sign of underlying glottal insufficiency . Otolaryngol Head Neck Surg . 2002;127:448–451
- . The irritable larynx syndrome . J Voice . 1999;13:447–455
PII: S1016-3190(10)60007-9
doi:10.1016/S1016-3190(10)60007-9
© 2007 Buddhist Compassion Relief Tzu Chi Foundation. Published by Elsevier Inc. All rights reserved.
