Ep. 116 Chronic Cough with Dr. Karuna Dewan

In this episode of BackTable ENT, Dr. Shah and Dr. Karuna Dewan discuss diagnosis, workup and medical therapy for chronic cough in adults. --- CHECK OUT OUR SPONSOR Cook Medical Otolaryngology https://www.cookmedical.com/otolaryngology --- SHOW NOTES First, they discuss the array of surveys used to quantify and assess the severity of the cough, as well as the importance of physical exam and laryngoscopy for an accurate diagnosis. They also outline various diagnoses that could be contributing to the chronic cough. Next, the critical role of speech pathologists in dysphagia diagnosis and management is explored. Dr. Dewan emphasizes the importance of the scope exam, as well as how speech pathologists are integral to the dysphagia diagnosis. Various testing options are discussed, such as modified barium swallow, esophagram, and pulmonary function testing. She then delves into how to decide which tests are necessary for each patient. Then, they discuss various treatments and medications for chronic coughing, including reflux medications, proton pump inhibitors, and steroids. They explore the importance of taking into account the potential side effects of these medications and of monitoring them closely. Additionally, they evaluate the efficacy of Tessalon perles, over the counter cough suppressants, and the two-arm approach for treating neurogenic cough. They also explain paradoxical vocal cord motion, its symptoms, and how it is treated with therapy and an ipratropium bromide inhaler. Procedures, like the superior laryngeal nerve block injections, may be effective for treating chronic cough. Finally, the doctors reflect on the use of social media for professional purposes. They consider how to best use Twitter and Instagram to promote oneself, and the importance of having an easily accessible profile on the Internet. They also touch on the importance of developing an online presence in order to stay connected and visible in the professional world.