対応に悩む喉頭疾患 —慢性咳嗽—

抄録

Chronic cough, which persists for more than eight weeks, results in a significant impairment of the quality of life. The JRS Guidelines for the Management of Cough and Sputum 2019 shows the diagnostic algorithms for chronic cough. However, some patients with chronic cough seem to have an unknown etiology, making them difficult to treat. Since the larynx plays a crucial role in protecting the lower airway from aspiration via coughing, the laryngopharynx is a sensitive organ. Therefore, laryngopharyngeal reflux (LPR), even when receiving proton pump inhibitor (PPI) therapy, can cause coughing. Because LPR disease (LPRD) is not easy to diagnose, it is important to measure LPR using hypopharyngeal multichannel intraluminal impedance pH metry (HMII) for patients with chronic cough of unknown etiology. We showed that 73% of patients with chronic cough were diagnosed with LPRD, and 73% of those with chronic cough diagnosed with LPRD became asymptomatic after antireflux surgery. LPRD should be distinguished from chronic cough of unknown etiology.