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Botox Injections Resolve Chronic Cough

In small case series, botulinum toxin type A resolved chronic cough in adults

THURSDAY, May 20 (HealthDay News) -- Injection with botulinum toxin type A (BtxA) can resolve chronic cough caused by laryngeal hypertonicity and neuroplastic changes, according to research published in the May issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Michael W. Chu, M.D., of Eastern Virginia Medical School in Norfolk, and colleagues reviewed outcomes for four patients (three women, one man; mean age 55.6 years) with laryngeal spasm and chronic cough who were treated with electromyography-guided injections of BtxA to the thyroarytenoid muscles.

In all four patients, the condition completely resolved after a median of 7 injections at a mean dose of 4.0 U per treatment over a mean treatment duration of 25.7 months. There were no major complications reported in any of the patients, though two patients reported developing breathiness in their voices.

"In this small case series, we report a neuropathic model for chronic cough caused by neuroplastic changes and laryngeal hyperactivity as an explanation for the effectiveness of BtxA treatment. Further research and long-term follow-up are warranted, but BtxA is effective in directly decreasing laryngeal hypertonicity and possibly reducing neurogenic inflammation and neuropeptide-mediated cough. Botulinum toxin type A can be considered for the treatment of chronic cough refractory to other medical therapies," the authors write.

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