Laryngeal Dysfunction Manifesting as Chronic Refractory Cough and Dyspnea Laryngeal Physiology in Respiratory Health and Disease

Chest. 2024 Mar 18:S0012-3692(24)00396-9. doi: 10.1016/j.chest.2024.03.026. Online ahead of print.ABSTRACTTOPIC IMPORTANCE: Laryngeal dysfunction as a cause of chronic refractory cough (CRC) and episodic dyspnea is often missed which results in unnecessary testing and delays in diagnosis. Understanding laryngeal roles in breathing and airway protection can help to appreciate the propensity to laryngeal dysfunction with aging, chronic lung disease and sleep apnea.REVIEW FINDINGS: The human larynx is a complex muscular structure that undertakes multiple roles of breathing, vocalization, coughing and swallowing. To undertake these activities, the larynx has a high density of sensory and motor innervation. Besides common embryological origins with the pharynx and esophagus with which many laryngeal activities are shared, somatomotor and autonomic pathways regulate emotional, cognitive and complex motor sequence-planning activities within the larynx. Due to its unique location, the larynx is susceptible to infectious and gastroesophageal reflux-related insults. Couple this with key roles in regulation of airflow and mediation of airway protective reflexes, it is not surprising that neuropathic abnormalities and muscle dysfunction can develop frequently. The expression of laryngeal dysfunction as hypersensitivity to mechanical, thermal, chemical and other stimuli leads to exaggerated airway protective reflexes (laryngeal adductor reflex and cough reflex) manifesting as dyspnea and ...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research