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Purpose of review Otolaryngologists are vital to successfully managing chronic cough in adults. This review presents updates regarding rapidly evolving concepts in chronic cough. Recent findings Significant growth is occurring in chronic cough research, strengthening the evidence of its major psychosocial impacts. Elucidation of the neural underpinnings of normal and abnormal cough within both the peripheral and central nervous systems highlight the previously underappreciated complexity of cough. Recent clinical practice recommendations emphasize personalized treatment approaches through addressing treatable traits of chronic cough. Investigations are ongoing to better distinguish chronic cough subgroups, and multiple types of important clinical outcome measures are being characterized. Newer research about chronic cough treatment encompasses pharmacologic and nonpharmacologic interventions, including oral and inhaled medications, superior laryngeal nerve blocks, and behavioral therapy. Summary As knowledge about chronic cough in adults continues to expand in both research and clinical practice, otolaryngologists can continue to raise awareness of the role of the larynx in cough and promote ongoing multidisciplinary collaborations. In the coming years, more pharmacologic options and personalized treatment approaches will likely emerge for chronic cough.
Purpose of review Otolaryngologists are vital to successfully managing chronic cough in adults. This review presents updates regarding rapidly evolving concepts in chronic cough. Recent findings Significant growth is occurring in chronic cough research, strengthening the evidence of its major psychosocial impacts. Elucidation of the neural underpinnings of normal and abnormal cough within both the peripheral and central nervous systems highlight the previously underappreciated complexity of cough. Recent clinical practice recommendations emphasize personalized treatment approaches through addressing treatable traits of chronic cough. Investigations are ongoing to better distinguish chronic cough subgroups, and multiple types of important clinical outcome measures are being characterized. Newer research about chronic cough treatment encompasses pharmacologic and nonpharmacologic interventions, including oral and inhaled medications, superior laryngeal nerve blocks, and behavioral therapy. Summary As knowledge about chronic cough in adults continues to expand in both research and clinical practice, otolaryngologists can continue to raise awareness of the role of the larynx in cough and promote ongoing multidisciplinary collaborations. In the coming years, more pharmacologic options and personalized treatment approaches will likely emerge for chronic cough.
Chronic cough is a frequent reason for medical consultation and has significant impact on quality of life. Due to the limited effectiveness of currently available treatments, and delays in accessing care, patients are often inadequately managed. There also remains an overreliance by clinicians on outdated management algorithms, addressing chronic cough only as symptom of other medical conditions, and advocating investigation and trials of treatment of diseases which are often not present. This may lead to unnecessary cost, frustration, and potential harm. Newer clinical guidelines in essence consider chronic cough as a disease in itself, resulting from afferent neuronal hypersensitivity and central nervous system dysfunction. Secondary factors which aggravate chronic cough (smoking, asthma, gastroesophageal reflux, etc), are better considered as treatable traits associated with the primary disease process rather than direct “causes” of cough.Explicitly approaching chronic cough as a discrete entity is consistent with the way in which “diseases” are generally characterised, and has advantages. The patient should be better able to understand their condition, and may have better confidence in attempts at management. The clinician should have better focus and avoid unfruitful treatments and investigation. In general, considering chronic cough as a disease should also help to raise the profile of the condition, improve organisation of health service pathways, increase attention for research, and further the development of new treatments.
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