Aerodigestive Approach to Chronic Cough in Children

Abstract

Purpose of review: Chronic cough is the most common presenting complaint in a pediatric aerodigestive clinic. The etiology of chronic cough is varied and often includes more than one organ system. This review aims to summarize the current literature for a multidisciplinary approach when evaluating a child with chronic cough. Recent findings: There is very little medical literature focused on a multidisciplinary approach to chronic cough. In the limited data available, multidisciplinary clinics have been shown to be more cost-efficient for the families of children with complex medical problems, and also increase the likelihood of successfully obtaining a diagnosis. Summary: There is no consensus in the literature on how to work-up a child with chronic cough presenting to an aerodigestive clinic. Current studies from these clinics have shown improved outcomes related to cost-effectiveness and identifying definitive diagnoses. Future studies evaluating clinical outcomes are necessary to help delineate the utility of testing routinely performed, and to demonstrate the impact of interventions from each specialty on quality of life and specific functional outcome measures.

Multidisciplinary approach to paediatric aerodigestive disorders: A single‐centre longitudinal observational study

“…This is possibly expected considering the majority of our cohort is made up of surgically corrected congenital airway conditions predisposing to poor mucociliary clearance. 14,15 A wide range of prevalence of respiratory infections has been reported in different studies (11-48%) in cases of surgically managed OA and TOF in the first 5 years of life. 10,16 In our cohort, recent lower respiratory tract infections were noted in 21% of all cases.…”

Pediatric Quality-of-Life Scores Following a Multidisciplinary Aerodigestive Team Approach to Manage Chronic Cough

“…Having participated in many ADC scientific events, we have observed that our ADC approach to patient management is quite similar to that of other North American institutions. 6,18,19 The inherently heterogeneous presenting features, prior treatments, physical findings and diagnostic results of the ADC patient population warrants a tailored, and consequently heterogeneous approach, to management.…”

Experiencia de una unidad aerodigestiva pediátrica en Latinoamérica

“…El hallazgo laringoscópico predominante de laringomalacia no debe pasarse por alto, ya que; al ser una patología estructural congénita puede ser una importante causa o comorbilidad de problemas de deglución, reflujo gastroesofágico, fallo para progresar y tos crónica (Naime et al, 2018). Esta patología es la más frecuente en las anomalías congénitas de la laringe y se considera que resolverá de forma espontánea en casi todos los casos.…”

“…Las broncoscopias brindaron información importante respecto a la etiología de la sintomatología del paciente, como es el caso del hallazgo de bronquitis bacteriana recurrente. Tomando en cuenta que la bronquitis bacteriana prolongada es la primera causa de tos húmeda persistente en niños menores de 5 años, el diagnóstico microbiológico es fundamental para una mejor orientación terapéutica en función de la persistencia del proceso bronquial (Naime et al, 2018). Los patógenos más frecuentes evidenciados mediante cultivo de lavado broncoalveolar fueron muy similares a los reportados como principales entidades en otros estudios, por ejemplo, en el informe del Sistema Nacional de Salud de Michigan (Fracchia et al, 2018).…”

“…decisión que se puede valorar de mejor manera al estar presente el equipo multidisciplinario al momento de realizar la triple endoscopia y la evaluación como unidad aerodigestiva pediátrica (Naime et al, 2018).…”