Benign Vocal Fold Lesions in Patients with Chronic Cough

• Published in: Otolaryngology-head and neck surgery 2020-03, Vol.162 (3), p.322-325
• Main Authors: Adessa, Michelle, Xiao, Roy, Hull, Darcey, Bowen, Andrew J., Milstein, Claudio F., Benninger, Michael S., Bryson, Paul C.
• Format: Article
• Language: English
• Subjects: benign vocal fold lesions; chronic cough; Leicester Cough Questionnaire
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599819900505

Objective The objective of this study was to determine the prevalence of benign vocal fold lesions (BVFLs) in patients with chronic cough over a 1-year period. Study Design Case series with chart review. Setting Tertiary academic medical center. Subjects and Methods A retrospective cohort study of patients with chronic cough seen in our tertiary multidisciplinary cough clinic from 2016 to 2017 was conducted. Patient characteristics, presence of BVFLs by laryngoscopy, and Leicester Cough Questionnaire (LCQ) were recorded. Results A total of 419 patients were included (average age: 61 years), and 67% of patients were female. Ten percent of patients had BVFLs: granuloma (5%), leukoplakia (3%), nodules (2%), and polyps (1%). Median cough duration was 2.9 years (interquartile range [IQR], 0.7-8.5); no significant difference in median cough duration was observed between patients with BVFLs and those with no lesions (2.6 vs 3.0 years, P = .86). In total, 178 patients (42%) had available LCQ data: median score of 10.2 (IQR, 7.9-13.9); no significant difference in median LCQ was observed between patients with BVFLs and those with no lesions (10.5 vs 10.1, P = .54). Conclusion Prevalence of BVFLs in our cohort of patients with chronic cough was 10%, with posterior glottic lesions—granuloma—being the most common (5%). Prevalence of midmembranous lesions was as follows: vocal fold nodules (2%) and vocal fold polyps (1%). BVFLs were not associated with longer cough duration or more severe cough. We cannot determine a causative or noncausative relationship between BVFLs and chronic cough at this time due to lack of a control group.