Botox for Chronic Cough

There was a new report in the May 2010 issue of Archives of Otolaryngology-Head & Neck Surgery that discussed the use of botox to achieve significant improvement, if not cure, in adult patients with a chronic cough due to sensory neuropathy. In this report titled "Use of Botulinum Toxin Type A for Chronic Cough: A Neuropathic Model", there are 4 case studies that were presented. The results they reported stated that cough relief occurred after a median of 7 injections with a mean dose of 4.0 Units per treatment session for a mean duration of 25.7 months. To watch a video of how the botox is injected into the voicebox to treat chronic cough, click here (the procedure is the same as that performed for spasmodic dysphonia).

Of note, this is the 2nd report on use of botox for chronic cough, the first was published in 2007 in ENT Journal and was done on kids. Click here to read that report.

I tend to use botox as a last resort when other medical management strategies have failed. Hidden triggers of cough including reflux, allergies, and asthma need to be addressed prior to consideration of botox. Often, I'll give a trial of neuropathic medications if laryngeal sensory neuropathy is suspected.

To read more about chronic cough, click here.

To read the actual report on use of botox to treat chronic cough, click here.

Botox is performed by Dr. Chang every Friday afternoon for spasmodic dysphonia, laryngospasm, as well as chronic cough! We also use botox for migraines, facial wrinkles, and torticollis.

Chronic Cough May Be Due to Obstructive Sleep Apnea!

A new study was published in the April 2010 journal Cough entitled "Chronic cough and obstructive sleep apnea in a community-based pulmonary practice."

Apparently 44% of patients with a chronic mysterious cough were found to have obstructive sleep apnea. In these patients, 93% had cough improvement when the obstructive sleep apnea was corrected!

Read the abstract here.

Of course, there are many other causes of chronic cough including reflux, asthma, allergies, etc. In rare cases, when all else comes back normal, the cough may be due to laryngeal sensory neuropathy.

Dr. Christopher Chang Recently Featured in Regional Serial Publication

Dr. Chang was recently featured in Healthy Happenings, a regional quarterly publication. The article mainly focused on one of Dr. Chang's patient whom he had diagnosed and successfully treated for laryngeal sensory neuropathy as a cause of her chronic cough for over 10 years.

To read the article, click here.