Abstract：
OBJECTIVE: Determine the effect of temporary vocal fold augmentation on refractory chronic cough (RCC) in patients with glottic insufficiency (GI) due to vocal fold atrophy.
METHODS: Retrospective electronic chart review was conducted for patients with a diagnosis of bilateral vocal fold atrophy and RCC undergoing vocal fold augmentation with carboxymethylcellulose (CMC). Patients with vocal fold immobility were excluded, and cough must have been present for at minimum 8weeks. VHI-10, CSI, and RSI scores along with subjective overall patient report of chronic cough improvement were collected.
RESULTS: A total of 28 patients underwent 30 vocal fold augmentation procedures with CMC. All had undergone extensive cough work-up and treatment trials prior to their augmentation procedure. From chart review, 13 overall subjectively reported satisfactory improvement in their cough, 5 reported partial improvement, and 7 reported no improvement in their cough. An uncertain effect on cough was documented in 5 (either patient was uncertain or no mention of cough symptom in the interval chart history note). For those subjects with both pre- and post-augmentation data, mean preaugmentation CSI: 22.08± 6.8 (n = 13); VHI-10: 13.6± 8.9 (n = 18); RSI: 22.4± 7.5 (n = 17). Mean postaugmentation CSI was 20.7± 9.2 (n = 13); VHI-10: 15.2± 8.2 (n = 18); RSI: 21.1± 5.8 (n = 17). Mean pre-post change in CSI was -1.4± 5.1 (P = 0.175, n = 13, range -10 to +6).
CONCLUSIONS: Vocal fold augmentation seems to provide subjective cough improvement in some patients with concurrent GI due to vocal fold atrophy and RCC. It can be offered as a diagnostic trial, on which further augmentation may be offered, for patients with persistent cough despite prior work-up and treatment trials. Further controlled prospective studies are needed to identify factors that are predictive of successful cough improvement following vocal fold augmentation, as well as the effect of durable augmentation in those patients who had improvement with a diagnostic trial.
METHODS: Retrospective electronic chart review was conducted for patients with a diagnosis of bilateral vocal fold atrophy and RCC undergoing vocal fold augmentation with carboxymethylcellulose (CMC). Patients with vocal fold immobility were excluded, and cough must have been present for at minimum 8weeks. VHI-10, CSI, and RSI scores along with subjective overall patient report of chronic cough improvement were collected.
RESULTS: A total of 28 patients underwent 30 vocal fold augmentation procedures with CMC. All had undergone extensive cough work-up and treatment trials prior to their augmentation procedure. From chart review, 13 overall subjectively reported satisfactory improvement in their cough, 5 reported partial improvement, and 7 reported no improvement in their cough. An uncertain effect on cough was documented in 5 (either patient was uncertain or no mention of cough symptom in the interval chart history note). For those subjects with both pre- and post-augmentation data, mean preaugmentation CSI: 22.08± 6.8 (n = 13); VHI-10: 13.6± 8.9 (n = 18); RSI: 22.4± 7.5 (n = 17). Mean postaugmentation CSI was 20.7± 9.2 (n = 13); VHI-10: 15.2± 8.2 (n = 18); RSI: 21.1± 5.8 (n = 17). Mean pre-post change in CSI was -1.4± 5.1 (P = 0.175, n = 13, range -10 to +6).
CONCLUSIONS: Vocal fold augmentation seems to provide subjective cough improvement in some patients with concurrent GI due to vocal fold atrophy and RCC. It can be offered as a diagnostic trial, on which further augmentation may be offered, for patients with persistent cough despite prior work-up and treatment trials. Further controlled prospective studies are needed to identify factors that are predictive of successful cough improvement following vocal fold augmentation, as well as the effect of durable augmentation in those patients who had improvement with a diagnostic trial.
摘要：
目的：确定暂时性声带增大对声带萎缩引起的声门功能不全（GI）患者难治性慢性咳嗽（RCC）的影响。
方法：对诊断为双侧声带萎缩和RCC的患者进行了用羧甲基纤维素（CMC）增强声带的回顾性电子图表回顾。声带不活动的患者被排除在外，咳嗽必须存在至少8周。VHI-10CSI,收集RSI评分以及患者慢性咳嗽改善的主观总体报告.
结果：共有28例患者接受了30例CMC声带增强术。在进行增强程序之前，所有人都经历了广泛的咳嗽检查和治疗试验。从图表审查来看，总体上有13人主观地报告了他们咳嗽的令人满意的改善，5报告了部分改进，和7报告他们的咳嗽没有改善。在5中记录了对咳嗽的不确定影响（在间隔图表历史记录中，患者不确定或未提及咳嗽症状）。对于那些同时具有扩增前和扩增后数据的受试者，平均扩增前CSI：22.08±6.8（n=13）；VHI-10：13.6±8.9（n=18）；RSI：22.4±7.5（n=17）。增强后平均CSI为20.7±9.2（n=13）；VHI-10：15.2±8.2（n=18）；RSI：21.1±5.8（n=17）。CSI的平均前后变化为-1.4±5.1（P=0.175，n=13，范围-10至6）。
结论：声带增大似乎可改善一些因声带萎缩和肾癌并发胃肠道的患者的主观咳嗽。它可以作为诊断试验提供，可以提供进一步的增强，对于持续咳嗽的患者，尽管之前进行了检查和治疗试验。需要进一步的对照前瞻性研究来确定声带增强后咳嗽成功改善的预测因素。以及在诊断试验中改善的患者中持续增强的效果。
方法：对诊断为双侧声带萎缩和RCC的患者进行了用羧甲基纤维素（CMC）增强声带的回顾性电子图表回顾。声带不活动的患者被排除在外，咳嗽必须存在至少8周。VHI-10CSI,收集RSI评分以及患者慢性咳嗽改善的主观总体报告.
结果：共有28例患者接受了30例CMC声带增强术。在进行增强程序之前，所有人都经历了广泛的咳嗽检查和治疗试验。从图表审查来看，总体上有13人主观地报告了他们咳嗽的令人满意的改善，5报告了部分改进，和7报告他们的咳嗽没有改善。在5中记录了对咳嗽的不确定影响（在间隔图表历史记录中，患者不确定或未提及咳嗽症状）。对于那些同时具有扩增前和扩增后数据的受试者，平均扩增前CSI：22.08±6.8（n=13）；VHI-10：13.6±8.9（n=18）；RSI：22.4±7.5（n=17）。增强后平均CSI为20.7±9.2（n=13）；VHI-10：15.2±8.2（n=18）；RSI：21.1±5.8（n=17）。CSI的平均前后变化为-1.4±5.1（P=0.175，n=13，范围-10至6）。
结论：声带增大似乎可改善一些因声带萎缩和肾癌并发胃肠道的患者的主观咳嗽。它可以作为诊断试验提供，可以提供进一步的增强，对于持续咳嗽的患者，尽管之前进行了检查和治疗试验。需要进一步的对照前瞻性研究来确定声带增强后咳嗽成功改善的预测因素。以及在诊断试验中改善的患者中持续增强的效果。
