Patients with chronic cough refractory to medical treatment may have an underlying vocal cord dysfunction (VCD) that is amenable to speech pathology.
According to a comparison of 51 patients with VCD and 39 patients with chronic cough from the John Hunter Hospital in Newcastle, the two conditions overlap.
The cross-sectional study found cough frequency was increased beyond the normal range in patients with VCD and their cough-related quality of life score was reduced.
Laryngoscopy findings were similar in the two groups with paradoxical vocal fold movement (PVFM) the defining criteria in all VCD patients and moderate-to-severe PVFM found in 69% of patients with chronic cough.
Abnormal vocal fold closure during phonation was also present in patients with chronic cough and similar between the VCD and chronic cough groups (78.4% v 64.1%; p=0.24).
“Although VCD is considered a disorder affecting respiration, this study shows that cough is a common and burdensome symptom in VCD, and that VCD should be considered as a potential diagnosis in patients with chronic cough. VCD could be a cause or a relevant comorbidity in chronic cough,” the study said.
Lead author and speech pathologist Dr Anne Vertigan told the limbic VCD was not always recognised in someone with chronic cough so people could be missing out on effective therapy.
“The primary treatment for VCD is speech pathology. We teach patients to breathe without constricting their larynx, so they get control over the vocal cords without spasming.”
She said many patients respond within three to four sessions.