Lung

, Volume 190, Issue 1, pp 35–40 | Cite as

The Role of Speech Pathology in the Management of Patients with Chronic Refractory Cough

Article

Abstract

Cough remains refractory to medical treatment in approximately 20% of cases. Speech pathology intervention is a useful treatment option for patients with chronic cough that is refractory to treatment based on the anatomic diagnostic protocol. One of the reasons for this is that the larynx can be implicated in the pathogenesis of chronic refractory cough. There is an overlap in symptoms and clinical findings in patients with cough and those with laryngeal conditions such as paradoxical vocal fold movement. Furthermore, there is a high prevalence of voice symptoms in patients with chronic cough. Speech pathology intervention for cough comprises four components: (1) education, (2) strategies to control cough, (3) vocal hygiene training, and (4) psychoeducational counselling. The efficacy of speech pathology intervention has been examined in a single blind randomised control trial. In this trial 87% of patients in the treatment group improved, whereas 14% on the placebo group improved. Cough reflex sensitivity has also been shown to improve following speech pathology intervention for cough. This review outlines the potential mechanisms for improvement in cough, indicators for referral to speech pathology for cough, and exclusion criteria.

Keywords

Chronic cough Voice therapy Paradoxical vocal fold movement 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Speech Pathology DepartmentJohn Hunter HospitalNewcastleAustralia
  2. 2.Department of Respiratory MedicineJohn Hunter Hospital, Hunter Medical Research InstituteNewcastleAustralia
  3. 3.Woodcock Institute of Medical ResearchGlebeAustralia

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