Speech therapy in the management of difficult-to-treat chronic cough - preliminary results.

INTRODUCTION: The efficacy of management of chronic cough in adults is limited. Speech therapy is one of the few therapeutic methods which seems to be useful in patients with persistent chronic cough. However, the method has not been available in Poland so far. The aim of the study was to implement speech therapy and assess its efficacy in the management of patients with difficult-to-treat chronic cough. MATERIAL AND METHODS: Patients, who were diagnosed and managed due to difficult-to-treat chronic cough, were enrolled into the study. Speech therapy was developed on the basis of the technique described by Vertigan. The entire therapy consisted of eight weekly sessions, each lasting 45 minutes. Before and after speech therapy, cough severity and its impact on the quality of life was assessed by the Visual Analogue Scale (VAS) and Leicester Cough Questionnaire (LCQ). Additionally, cough challenge test with capsaicin was performed. RESULTS: Eighteen women were enrolled into the study, 15 of them (83%) attended all treatment sessions (median age 66 years, median duration of cough 60 months). There was a significant decrease in cough severity measured by VAS (46 vs 28 mm, p = 0.016) after completion of speech therapy. A significant improvement in patients' quality of life measured by LCQ (10.7 vs 14.6 points, p = 0.004) and an increase in the threshold of cough reflex measured by capsaicin challenge were also demonstrated. CONCLUSIONS: Speech therapy resulted in a decrease in cough severity and improvement of quality of life of females with refractory chronic cough. Our results support the use of speech therapy as add-on treatment in females with difficult-to-treat cough.

Speech therapy - a non-pharmacological method to manage difficult-to-treat chronic cough.

Cough is the most common symptom of respiratory diseases. The results of management of chronic cough in adults are still unsatisfactory. Unexplained and difficult-to-treat chronic cough causes significant impairment in patients' quality of life. The results of recent studies suggest that speech therapy (speech language intervention) is one of the few methods which are usefull in management of persistent chronic cough. We present a case of a patient with chronic cough due to chronic nonallergic rhinitis and gastroesophageal reflux disease, who had been unsuccessfully treated for 18 years. In the patient speech therapy resulted in a significant decrease of cough severity and improvement of quality of life.

[Primary location of non-Hodgin's lymphoma (type MALT) in hypopharynx--case report]. / Przypadek nieziarniczego chloniaka zlosliwego (typu MALT) w gardle dolnym.

A rare case of MALT lymphoma of the hypopharynx is presented. The study was focused on case history, symptoms and management. In the following paper the theories and classification of non-Hodgin's lymphoma are presented.