Przewlekły kaszel w praktyce otorynolaryngologicznej

Abstract

Cough is the most common symptom of the upper and lower airway diseases. In its nature, cough is a defence reflex mechanism of the respiratory tract that is used to clear the upper airways. Persistent cough is associated with a whole range of conditions, both respiratory and non-respiratory disorders. Chronic cough, defined as cough lasting for more than 8 weeks, is reported by 3–40% if the general population and has an important impact on patients' quality of life. In non-smokers upper airways cough syndrome, previously referred to as post nasal drip syndrome is one of the most common causes of chronic cough with asthma and gastroesophageal reflux. Chronic cough in majority of cases is related to more than one disease. The pathogenesis of cough from UACS remains unclear, but some authors indicate, that extrathoracic airway hyperresponsiveness – EAHR could be the responible mechanism. Chronic cough can present difficulties in diagnosis and management. Otorhinolaryngological assessment seems to be necessary component of diagnostic proccess, particularly in non-smoking, not-treated with ACEinhibitors adults with normal chest radiogram and excluded lower airways pathology. ENT approach in chronic cough could based on: ENT medical history and ENT examination, sinus CT scans, videolaryngoscopy, acoustic rhinometry, rhinomanometry, nasal cytology and nasal-sinus endoscopy. Such complex diagnostic tools, included otorhinolaryngological procedures, in many cases are necessary to recognized the cause of chronic cough and to establishe the accurate diagnosis, which implies a higher chance to effective treatment.