Seeing the Forest Through the Wheeze: Laryngeal Involvement in ...

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Cough – Clinical Presentation • School age children to older adults • Average length of cough months to years • Most pts have attempted multiple interventions w/o resolving of cough • Most have associated fatigue • Most do not have accompanying hoarseness • Most have been treated for reflux for a short period of time w/o success
Cough • Habit/chronic cough – Larynx engaged in disordered loop of behavior • Psychogenic cough – Cough occurs secondary to emotional/psychological issues • Laryngeal hypersensitivity/hyper-reactivity – Larynx over-reacts to triggering stimuli secondary to irritation of the larynx by refluxed stomach contents • Neuropathic cough – Cough occurs secondary to viral neuropathy • Cough Hypersensitivity Syndrome (Morice, 2009) – Th2-type immune response vs. reflux symptoms
Page 1 and 2:
Seeing the Forest Through the Wheez
Page 3 and 4:
Larynx • Cartilaginous tube - Con
Page 5 and 6:
Larynx • Upper rim of larynx form
Page 7:
Larynx • Most inferiorly are true
Page 10 and 11:
Neurologic Supply • Superior lary
Page 13 and 14: Larynx
Page 15 and 16: Upper Airway Issues that can Compro
Page 17 and 18: Bilateral Vocal Fold Paralysis
Page 19 and 20: Laryngeal Papilloma
Page 21 and 22: Vocal Fold Granuloma
Page 23 and 24: Laryngomalacia
Page 25 and 26: Lower Airway Issues that can • As
Page 27 and 28: Chronic Illnesses/Disorders That Ca
Page 37 and 38: Case Study #1 • 41 year-old femal
Page 39 and 40: • Treatment Case Study #1 - Speec
Page 41 and 42: Irritable Larynx Syndrome Chronic T
Page 43 and 44: These Behaviors Include: • Muscle
Page 45 and 46: Muscle Tension Dysphonia • In add
Page 47 and 48: Globus • “Lump in throat” sen
Page 49 and 50: For All of These Behaviors • Lary
Page 51 and 52: ILS - Inclusion Criteria • Sympto
Page 53 and 54: Patients with Dx of ILS • Tend to
Page 55 and 56: • Airborne irritants • Reflux T
Page 57 and 58: Hypothesis for ILS • Develops as
Page 59 and 60: Cough • Important respiratory def
Page 61 and 62: Cough - Differential Diagnosis •
Page 63: Cough - Differential Diagnosis •
Page 67 and 68: Cough - Tx • Habit/chronic cough
Page 69 and 70: • Sudden onset IVFC - Symptoms
Page 71 and 72: IVFC Mimicking Asthma - Symptoms ea
Page 73 and 74: IVFC - Evaluation • History - Acu
Page 75 and 76: Case Study #2 • 13 year-old femal
Page 77 and 78: Case Study #2 • During flexible e
Page 79 and 80: Bibliography • Christopher, K.L.,
Page 81 and 82: Bibliography • Altman, K.W., Simp
Page 83: Bibliography • Brugman, S.M.: Wha
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Seeing the Forest Through the Wheeze: Laryngeal Involvement in ...

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