Laryngeal Electromyographic Findings in a Cohort of Recalcitrant Chronic Neurogenic Cough Patients

Zalvan, Craig H.; Yuen, Erick; Thomas, Anila; Benson, Brian

doi:10.1016/j.jvoice.2020.01.024

Cited by 5 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For those who undergo treatment, several studies have demonstrated improvement of both dysphagia and dysphonia with early initiation of speech therapy, as well as injection laryngoplasty 13,26‐31 . Injection laryngoplasty significantly reduces the rate of aspiration, returning patients to a regular diet 32‐39 . Patients with unilateral VFP who undergo early injection laryngoplasty are less likely to require long‐term medialization procedures in the form of thyroplasty than those who did not receive early injection laryngoplasty 40 .…”

Section: Resultsmentioning

confidence: 99%

“…Laryngeal electromyography (LEMG) has been suggested as useful in patients with voice complaints 57,58 especially when glottic configuration on laryngoscopy and stroboscopy appears normal but weakness is suspected 74 . It should be noted, however, that LEMG is not a reliable indicator of RLN injury, and EMG abnormalities are not common across the population 35,75,76 …”

Section: Resultsmentioning

confidence: 99%

“…13,[26][27][28][29][30][31] Injection laryngoplasty significantly reduces the rate of aspiration, returning patients to a regular diet. [32][33][34][35][36][37][38][39] Patients with unilateral VFP who undergo early injection laryngoplasty are less likely to require long-term medialization procedures in the form of thyroplasty than those who did not receive early injection laryngoplasty. 40 Investigations of treatments, like nimodipine in the acute period of VFP, are promising but requires further evaluation before being widely adopted.…”

Section: Statement 1: Immediate Vocal Fold Paralysismentioning

confidence: 99%

“…74 It should be noted, however, that LEMG is not a reliable indicator of RLN injury, and EMG abnormalities are not common across the population. 35,75,76 Implications and logistics of the laryngeal examination Per the current guidelines by the American Thyroid Association, 44 as well as the American Academy of Otolaryngology and AHNS, 18,77 the timeline suggested in assessment of immediate voice complaints is between 2 weeks to 2 months after surgery. Within this recommendation, voice assessment should include subjective patient reporting and an objective assessment of voice by an Otolaryngologist-Head and Neck Surgeon and Speech Language Pathologist.…”

Section: Statement 4: Standardized Approachmentioning

confidence: 99%

See 3 more Smart Citations

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

et al. 2020

View full text Add to dashboard Cite

Background: Laryngeal dysfunction after thyroid and parathyroid surgery requires early recognition and a standardized approach for patients that present with voice, swallowing, and breathing issues. The Endocrine Committee of the American Head and Neck Society (AHNS) convened a panel to define the terms "immediate vocal fold paralysis" and "partial neural dysfunction" and to provide clinical consensus statements based on review of the literature, integrated with expert opinion of the group. Methods: A multidisciplinary expert panel constructed the manuscript and recommendations for laryngeal dysfunction after thyroid and parathyroid surgery. A meta-analysis was performed using the literature and published guidelines. Consensus was achieved using polling and a modified Delphi approach. Results: Twenty-two panelists achieved consensus on five statements regarding the role of early identification and standardization of evaluation for patients with "immediate vocal fold paralysis" and "partial neural dysfunction" after thyroid and parathyroid surgery. Conclusion: After endorsement by the AHNS Endocrine Section and Quality of Care Committee, it received final approval from the AHNS Council.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Statement 1: Immediate Vocal Fold Paralysismentioning

confidence: 99%

Section: Statement 4: Standardized Approachmentioning

confidence: 99%

See 2 more Smart Citations

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Temperature changes, perfumes, aerosols, strong odors, speech, laughter, or singing often trigger chronic coughs. The exact reason for the existence of cough hypersensitivity syndrome is still unknown, but it is hypothesized that central and peripheral neural mechanisms play a role, forming the basis for the use of neuromodulatory drugs in the treatment of chronic cough 1,5 .…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and therapy of chronic cough

Sotirović

2023

Galenika Med J

View full text Add to dashboard Cite

A cough that lasts for more than 8 weeks in adults (those older than 15 years) and more than 4 weeks in children is considered chronic and poses a significant health problem, as it can lead to feelings of fatigue, sleep disturbances, hoarseness, disruption of daily activities, vomiting, and often in women, even incontinence. The differential diagnosis of chronic cough in adults and children has its specificities. In certain cases, the etiological factor remains unknown when referring to unexplained (idiopathic) chronic cough. This paper presents the results of a systematic review of publications in medical databases (PubMed) and guidelines from the European Respiratory Society (ERS) and the American College of Chest Physicians (CHEST), related to the diagnosis and treatment of chronic cough. Diagnostic investigations should be focused on the most common causes of chronic cough. In adults, these include asthma, chronic obstructive pulmonary disease, bronchiectasis, interstitial lung disease, lung malignancy, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease, and upper airway cough syndrome. In children, the most common causes of chronic cough are asthma, protracted bacterial bronchitis, cystic fibrosis, primary ciliary dyskinesia, bronchiectasis, tracheobronchomalacia, pertussis, habitual (psychogenic) cough, and foreign body aspiration. The treatment primarily involves excluding medications that might have chronic cough as an adverse effect. Therapy is directed toward treating the underlying cause of chronic cough. If the cough persists despite treatment (refractory cough) or if it's idiopathic, neuromodulatory medications are employed (opioids, gamma-aminobutyric acid analogs, tricyclic antidepressants). Therapeutic options also include breathing and vocal techniques, superior laryngeal nerve blocks, and vocal cord medialization injections. Drugs directly inhibiting sensory receptors (P2X3, TRPV-1, and NK-1 inhibitors) are currently under clinical trial investigation. The use of validated tests is crucial for assessing therapeutic effectiveness. The etiological factors of chronic cough can have both infectious and non-infectious origins and are not always related to lung diseases. Considering that chronic cough is regarded as a condition of hypersensitivity, when causal treatment does not yield satisfactory results or when dealing with idiopathic chronic cough, therapy is directed towards central or peripheral neuromodulation, as well as techniques involving breathing and vocal production.

show abstract

Efficacy of Botulinum A Injection to the Laryngeal Adductor Compartment for Treatment of Cough

Campbell,

Flormann,

Davis

et al. 2023

The Laryngoscope

View full text Add to dashboard Cite

ObjectivesStudies examining electromyography (EMG)‐guided laryngeal onobotulinumtoxinA (BTxA) injection for chronic cough reveal promising efficacy, however, are limited by small cohorts and absent quantifiable outcomes. It further remains unclear if pulmonary disease limits efficacy, or if vagal motor neuropathy prognosticates response. We hypothesize BTxA injection results in qualitative improvement in cough, decrease in Cough Severity Index (CSI), no change in Voice Handicap Index‐10 (VHI‐10), and complication rates comparable to historical data. We also examine the correlation of pulmonary comorbidities and vocal fold hypomobility with treatment efficacy.Study DesignRetrospective review.MethodsCharts for patients receiving percutaneous adductor compartment BTxA injection for cough were reviewed for the binary outcome of patient‐reported presence or absence of improvement. Generalized estimating equations regression models were used to analyze the change in CSI (ΔCSI) and the correlation of ΔCSI with qualitative outcomes. Multivariable analyses were used to examine correlation of vocal fold hypomobility and pulmonary disease with qualitative outcomes and ΔCSI.ResultsForty‐seven patients underwent 197 BTxA injections from June 2012 to June 2022. A statistical proportion of 0.698 (0.599–0.813, p < 0.0001) or 69.8% of injections resulted in subjective improvement. Mean ΔCSI was −2.12 (0.22–4.02, p < 0.05), indicating overall improvement. With and without subjective improvement, estimated ΔCSI was −4.43 and +2.68, respectively (p < 0.0001). VHI‐10 did not change (0.69, p = 0.483). Neither pulmonary disease nor vocal fold hypomobility correlated with subjective improvement or ΔCSI. Dysphagia occurred following 15 (7.6%) injections with no aspiration pneumonia or hospitalization.ConclusionsBTxA injection to the laryngeal adductors may effectively treat cough with limited risk for serious complications.Level of Evidence4 Laryngoscope, 2023

show abstract

Laryngeal Electromyographic Findings in a Cohort of Recalcitrant Chronic Neurogenic Cough Patients

Cited by 5 publications

References 20 publications

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

Diagnosis and therapy of chronic cough

Efficacy of Botulinum A Injection to the Laryngeal Adductor Compartment for Treatment of Cough

Contact Info

Product

Resources

About