Current Otorhinolaryngology Reports | 2019
Modern Challenges Managing Chronic Cough in Otolaryngology
Abstract
Purpose of ReviewCough is an increasingly important public health concern, and otolaryngologists play a critical role in these patients. Despite advances in best practice, there remain opportunities to improve coordination of care, as well as fostering a systematic approach to improve outcomes.Recent FindingsThe standard challenge is appreciating the multifactorial nature of chronic cough, primarily upper respiratory, lower respiratory, and upper gastrointestinal tract (e.g., gastric reflux and oropharyngeal swallowing disorders), in addition to tobacco use and angiotensin-converting enzyme inhibitors. Beyond the basic diagnostic problem, other areas have been identified that pose their own set of uncertainties, including (1) disseminating established best practice; (2) growing otolaryngologist’s recognition; (3) creating a multidisciplinary clinic; (4) formalizing protocolization and comparative effectiveness; (5) clarifying the ongoing controversy regarding relation of cough with reflux; (6) distinguishing between neurogenic, somatic, tic cough and the role of pharmacologic suppression; (7) evolving scientific understanding of cough; and (8) globalizing healthcare.SummaryThese modern challenges in part reflect changes in how we practice medicine today.