TY - JOUR
T1 - Curbing the Cough
T2 - Multimodal Treatments for Neurogenic Cough: A Systematic Review and Meta-Analysis
AU - Wamkpah, Nneoma S.
AU - Peterson, Andrew M.
AU - Lee, Jake J.
AU - Jia, Lena
AU - Hardi, Angela
AU - Stoll, Carolyn
AU - Huston, Molly
N1 - Funding Information:
Research reported in this publication was supported by the National Institute of Deafness and Other Communication Disorders within the National Institutes of Health (NIH) under Award Number 5T32DC000022 and by the National Center for Advancing Translational Sciences of the NIH under Award Number UL1TR002345. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2020 American Laryngological, Rhinological and Otological Society Inc, “The Triological Society” and American Laryngological Association (ALA)
PY - 2022/1
Y1 - 2022/1
N2 - Objectives/Hypothesis: Neurogenic cough affects 11% of Americans and causes significant detriment to quality of life. With the advent of novel therapies, the objective of this review is to determine how procedural therapies (e.g., superior laryngeal nerve block) compare to other established pharmacologic and non-pharmacologic treatments for neurogenic cough. Methods: With the assistance of a medical librarian, a systematic review was performed using PICOS (patients, interventions, comparator, outcome, study design) format: adults with neurogenic cough receiving any pharmacologic or non-pharmacologic treatment for neurogenic cough compared to adults with neurogenic cough receiving any other relevant interventions, or treated as single cohorts, assessed with cough-specific quality of life outcomes, in all study designs and case series with ≥ 10 cases. Case reports, review articles, non-human studies, non-English language articles, and unavailable full-text articles were excluded. Results: There were 2408 patients with neurogenic cough in this review, treated with medical therapy (77%), speech therapy (19%), both medical and speech therapy (1%), and procedural therapy (3%). The included studies ranged from low to intermediate quality. Overall, most interventions demonstrated successful improvement in cough. However, the heterogeneity of included study designs precluded direct comparisons between intervention types. Conclusion: This meta-analysis compared various treatments for neurogenic cough. Procedural therapy should be considered in the armamentarium of neurogenic cough treatments, particularly in patients refractory to, or intolerant of, the side effects of medical therapy. Lastly, this review illuminates key areas for improving neurogenic cough diagnosis, such as strict adherence to diagnostic and treatment guidelines, sophisticated reflux testing, and standardized, consistent outcome reporting. Laryngoscope, 132:107–123, 2022.
AB - Objectives/Hypothesis: Neurogenic cough affects 11% of Americans and causes significant detriment to quality of life. With the advent of novel therapies, the objective of this review is to determine how procedural therapies (e.g., superior laryngeal nerve block) compare to other established pharmacologic and non-pharmacologic treatments for neurogenic cough. Methods: With the assistance of a medical librarian, a systematic review was performed using PICOS (patients, interventions, comparator, outcome, study design) format: adults with neurogenic cough receiving any pharmacologic or non-pharmacologic treatment for neurogenic cough compared to adults with neurogenic cough receiving any other relevant interventions, or treated as single cohorts, assessed with cough-specific quality of life outcomes, in all study designs and case series with ≥ 10 cases. Case reports, review articles, non-human studies, non-English language articles, and unavailable full-text articles were excluded. Results: There were 2408 patients with neurogenic cough in this review, treated with medical therapy (77%), speech therapy (19%), both medical and speech therapy (1%), and procedural therapy (3%). The included studies ranged from low to intermediate quality. Overall, most interventions demonstrated successful improvement in cough. However, the heterogeneity of included study designs precluded direct comparisons between intervention types. Conclusion: This meta-analysis compared various treatments for neurogenic cough. Procedural therapy should be considered in the armamentarium of neurogenic cough treatments, particularly in patients refractory to, or intolerant of, the side effects of medical therapy. Lastly, this review illuminates key areas for improving neurogenic cough diagnosis, such as strict adherence to diagnostic and treatment guidelines, sophisticated reflux testing, and standardized, consistent outcome reporting. Laryngoscope, 132:107–123, 2022.
KW - Neurogenic cough
KW - chronic cough
KW - idiopathic cough
KW - laryngeal hypersensitivity
KW - neuromodulator
KW - superior laryngeal nerve block
UR - http://www.scopus.com/inward/record.url?scp=85092905842&partnerID=8YFLogxK
U2 - 10.1002/lary.29146
DO - 10.1002/lary.29146
M3 - Article
C2 - 33085095
AN - SCOPUS:85092905842
SN - 0023-852X
VL - 132
SP - 107
EP - 123
JO - Laryngoscope
JF - Laryngoscope
IS - 1
ER -