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<p>Chronic cough (CC), defined as a non-productive cough lasting over eight weeks, is a common and challenging presentation in otolaryngology. Laryngopharyngeal reflux (LPR), upper airway cough syndrome (UACS), and allergic rhinitis are frequent etiologies. Despite standard therapies, a subset of patients develops refractory chronic cough (RCC), requiring further diagnostic and multidisciplinary evaluation. This study aimed to assess the etiological spectrum, diagnostic methods, treatment outcomes, and predictors of refractory cases in an ENT-specific setting. A retrospective observational study was conducted at a tertiary care centre from January 2023 to December 2024. A total of 150 adults (aged 18–70&#xa0;years) with chronic cough (&gt; 8&#xa0;weeks) were evaluated using a structured diagnostic algorithm incorporating clinical history, flexible Naso-endoscopy, allergy testing, and chest radiography. Treatment was etiology-specific. Symptom resolution was assessed at baseline and at two, four, and six weeks using a 5-point Likert scale. Refractory cases underwent advanced investigations, including 24 h pH impedance monitoring. Logistic regression was used to identify predictors of poor treatment response. LPR was the leading etiology (40%), followed by allergic rhinitis (24.7%) and UACS (20%). Flexible Naso-endoscopy had the highest diagnostic yield (83.3%). Symptom resolution occurred in 85.3% of patients, while 14.7% remained refractory. Severe baseline symptoms, symptom duration &gt; 6&#xa0;months, and comorbidities were significant predictors of treatment failure (<i>p</i> &lt; 0.05). Structured diagnostic algorithms and multidisciplinary care improve chronic cough outcomes. Refractory cases benefit from individualized management, including neuromodulators, speech therapy, and surgical intervention where indicated.</p>

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Diagnostic and Therapeutic Strategies for Chronic Cough in Otolaryngology: A Retrospective Institutional Study

  • 期刊论文

  • 发表日期：

    2025年6月24日

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  • Srujan Vallur,
  • Snehangsh Dash,
  • Parthasarathi Ghana,
  • Sanjay Kumar

摘要

Chronic cough (CC), defined as a non-productive cough lasting over eight weeks, is a common and challenging presentation in otolaryngology. Laryngopharyngeal reflux (LPR), upper airway cough syndrome (UACS), and allergic rhinitis are frequent etiologies. Despite standard therapies, a subset of patients develops refractory chronic cough (RCC), requiring further diagnostic and multidisciplinary evaluation. This study aimed to assess the etiological spectrum, diagnostic methods, treatment outcomes, and predictors of refractory cases in an ENT-specific setting. A retrospective observational study was conducted at a tertiary care centre from January 2023 to December 2024. A total of 150 adults (aged 18–70 years) with chronic cough (> 8 weeks) were evaluated using a structured diagnostic algorithm incorporating clinical history, flexible Naso-endoscopy, allergy testing, and chest radiography. Treatment was etiology-specific. Symptom resolution was assessed at baseline and at two, four, and six weeks using a 5-point Likert scale. Refractory cases underwent advanced investigations, including 24 h pH impedance monitoring. Logistic regression was used to identify predictors of poor treatment response. LPR was the leading etiology (40%), followed by allergic rhinitis (24.7%) and UACS (20%). Flexible Naso-endoscopy had the highest diagnostic yield (83.3%). Symptom resolution occurred in 85.3% of patients, while 14.7% remained refractory. Severe baseline symptoms, symptom duration > 6 months, and comorbidities were significant predictors of treatment failure (p < 0.05). Structured diagnostic algorithms and multidisciplinary care improve chronic cough outcomes. Refractory cases benefit from individualized management, including neuromodulators, speech therapy, and surgical intervention where indicated.