The Diagnosis and Time of Onset of Voice Disorders in Patients with Chronic Cough

Jessica F Kim; WayAnne Watson; Benjamin J Becerra; Brianna K Crawley; Rim Saab; Priya Krishna; Thomas Murry

doi:10.1016/j.jvoice.2022.09.021

The Diagnosis and Time of Onset of Voice Disorders in Patients with Chronic Cough

J Voice. 2022 Nov 7:S0892-1997(22)00298-3. doi: 10.1016/j.jvoice.2022.09.021. Online ahead of print.

Authors

Jessica F Kim¹, WayAnne Watson², Benjamin J Becerra³, Brianna K Crawley², Rim Saab⁴, Priya Krishna², Thomas Murry⁵

Affiliations

¹ Loma Linda University School of Medicine, Loma Linda, CA. Electronic address: jessfkim@gmail.com.
² Loma Linda University Medical Center Department of Otolaryngology-Head and Neck Surgery, Loma Linda, CA.
³ California State University, Center for Health Equity Department of Information & Decision Sciences, San Bernardino, CA.
⁴ Drexel University School of Medicine, Philadelphia, PA.
⁵ Loma Linda University Medical Center Department of Otolaryngology-Head and Neck Surgery, Loma Linda, CA; Drexel University College of Medicine Department of Otolaryngology-Head and Neck Surgery, Philadelphia, PA.

PMID: 36357238
DOI: 10.1016/j.jvoice.2022.09.021

Abstract

Objectives: Chronic cough is a complaint of up to 46% of patients referred to specialist clinics. Patients with cough often report hoarseness at the time of the cough diagnosis. When the cough fails to resolve with standard medications, referrals to other specialists including otolaryngologists are made. This is the first study to report the specific diagnosis and length of time it took to obtain a specific voice disorder diagnosis in patients with chronic cough.

Study design: Case Series METHODS: The charts of 105 patients referred to the Loma Linda Voice and Swallowing Center were reviewed. The first complaint of cough and/or hoarseness and the specific voice disorder diagnosis following otolaryngologic evaluation were identified. Voice disorders were divided into neurogenic or other/functional disorders and common comorbidities were identified. Statistical analysis between diagnostic groups, gender, and age were obtained.

Results: The specific voice disorders in the cohort were identified. There was a high prevalence of neurogenic voice disorders (n = 85, 81%). There were significant relationships between chronic cough and the two most common neurogenic voice disorders, vocal fold paresis and vocal fold atrophy. The average length of time between complaint of hoarseness and the specific voice disorder diagnosis was 32.3 months. Most patients (86%) complained of voice problems after diagnosis of chronic cough. A significant association was found in prevalence of asthma (OR = 4.52, P = 0.02) and dyspnea (OR = 4.24, P = 0.02) in the cohort who presented first with voice complaints and later developed chronic cough.

Conclusions: There is a high incidence of neurogenic voice disorders accompanying patients with chronic cough. Understanding the relationship between chronic cough and hoarseness provides the clinician with specific diagnostic information in the treatment of both disorders.

Keywords: Chronic cough; Chronic refractory cough; Hoarseness; Neurogenic voice disorders.

Publication types

Case Reports