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A Primer on Hypotussic Cough: Mechanisms and Assessment

  • LARYNGOLOGY: UPDATE ON DYSPHAGIA (H STARMER AND A RAMEAU, SECTION EDITORS)
  • Published:
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Abstract

Purpose of Review

This narrative review introduces key elements of cough neural control, function, dysfunction, and measurement for physicians and speech-language pathologists. Its goal is to guide integrated approaches to the assessment of cough and facilitate differential diagnosis of cough dysfunction among people with dysphagia.

Recent Findings

Research has shown that cough and swallow dysfunction have high co-occurrence, especially in neurodegenerative populations. Both sensory and motor components of cough dysfunction can be evaluated using high and low-tech equipment (e.g., handheld peak flow meters). The evaluation of cough function is vital given the known benefit of targeted dystussia treatments for people with dysphagia.

Summary

Intact airway protection requires both functional swallowing and cough. However, clinicians report that objective cough evaluations are not commonly included in assessments of airway protection. This review provides an overview of cough neurobiology, describes its measurement, and presents case vignettes to illustrate the benefits of integrating cough assessments into clinical settings.

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Authors and Affiliations

  1. Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, 525 W 120th St, New York, NY, 10027, USA

    Emilie R. Lowell, James C. Borders, Jordanna S. Sevitz, Avery E. Dakin & Michelle S. Troche

  2. Department of Communicative Sciences and Disorders, New York University, 665 Broadway, New York, NY, USA

    Danielle Brates

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Dr. Troche reports the following: Financial: Salary — employment — Teachers College, NIH/NINDS — grant, and MedBridge Inc. — Royalty — Consulting. Non-financial: Dysphagia Research Society — professional — board membership, and Journal of Speech Language and Hearing Research — editorial board member. The other authors declare no competing interests.

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Lowell, E.R., Borders, J.C., Sevitz, J.S. et al. A Primer on Hypotussic Cough: Mechanisms and Assessment. Curr Otorhinolaryngol Rep 11, 182–191 (2023). https://doi.org/10.1007/s40136-023-00446-5

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