Cronic cough and laryngeal and neurological disease: a mulidisciplinar evaluation experience.

<bold>Introduction:</bold> Chronic cough is a frequent concern in Pulmonology, often requiring a thorough and complex approach in the absence of targeted treatments. <bold>Objectives:</bold> To perform a multidisciplinary assessment of patients with chronic cough lasting more than one year, whether unexplained or refractory. This includes determining the role of laryngeal pathology in these patients, who, after initial evaluation in our outpatient Pulmonology clinics, were referred to Otolaryngology and Neurology for stroboscopy, laryngeal electromyography, and genetic testing to exclude neurological disorders linked to chronic cough. <bold>Results:</bold> A total of 38 patients with chronic cough, either unexplained (71%) or refractory (29%), and lasting more than one year were assessed. Among these, 80% were female, with an average age of 62 years (±14), and 38.5% were ex-smokers. These individuals maintained preserved pulmonary function (FEV1 89% ± 23, FVC 88% ± 23, and FEV1/FVC 80% ± 9). Following evaluation in the outpatient Pulmonology clinics, patients were referred to the Otolaryngology and then to the Neurology services. Nine cases of laryngeal paralysis (23.7%) were identified, with six patients (67%) showing improvement in cough symptoms following radiofrequency treatment. Additionally, one patient was diagnosed with laryngeal denervation, and another with Holmes-Adie-Ross dysautonomia. Of the 38 patients, two were diagnosed with CANVAS disease (Cerebellar Ataxia, Neuropathy, and Vestibular Areflexia Syndrome). <bold>Conclusions:</bold> Chronic cough, particularly those cases persisting for more than one year, poses a significant diagnostic challenge, underscoring the importance of a multidisciplinary strategy for effective management.