Type 1 Thyroplasty for Chronic Cough

Abstract

Type 1 thyroplasty is a vital component of treatment for vocal fold hypomobility, immobility, and atrophy. However, patients with other laryngeal symptoms, including chronic cough, can have concomitant vocal fold atrophy and glottic insufficiency on the exam. Previous work has demonstrated that injection laryngoplasty can assist with treating cough in patients with glottic insufficiency. However, the role of type 1 thyroplasty for cough has not been well described. Case series of five patients treated by a fellowship-trained laryngologist at a tertiary voice center. Five patients underwent type 1 thyroplasty for chronic cough. All five patients had a chronic cough that was not responsive to medical management. One patient underwent a previous superior laryngeal nerve block, which was effective for three weeks. Prior to surgery, all patients had a trial injection laryngoplasty with temporary improvement in symptoms. Four of five patients underwent bilateral GoreTex type 1 thyroplasty; one underwent only unilateral thyroplasty due to subtle vocal fold hypomobility on that side. All patients had improvement in their cough, with follow-up periods ranging from one month to three years. There are limited therapeutic options for chronic cough refractory to medical therapy. For patients with vocal fold atrophy or glottic insufficiency, type 1 thyroplasty may offer a durable option to improve cough.