Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Psychogenic aphonia is a conversion symptom which is quite annoying to the patient. This article concentrates on the treatment of psychogenic aphonia. The literature contains only few articles on this subject. We present in detail a very efficient way of treatment with directive and biofeedback aspects. Central to the treatment is a direct approach of the symptom, based on the idea that due to the time factor the aphonia has become dissociated from the unconscious psychological conflict. The treatment starts with a double cough so that the vocal chords close. At the same time the ear, nose and throat specialist looks with the laryngoscope and corrects directly which gives an optimal learning effect. In 1988 and 1989, 23 patients were treated with this method. The duration of the aphonia varied from two weeks to two years. In eight of the patients the aphonia recurred. Patients were treated for a total of 45 episodes of aphonia. In all cases the voice returned within an hour.
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PMID:[Psychogenic aphonia; an effective and rapidly treatable conversion]. 163 May 27

Foreign bodies can become lodged anywhere in the air passages, depending on their size, shape, and makeup. Symptoms of laryngeal foreign body inhalation can vary greatly but usually include one or more of the following: hoarseness, croupy cough, stridor, wheezing, dyspnea, cyanosis, hemoptysis, aphonia, odynophagia, or a subjective feeling of the presence of a foreign substance. Foreign body inhalation occurs most often in children and the elderly. The symptoms of bronchial foreign body inhalation are very similar to those of laryngeal foreign body inhalation. Usually, after the initial expression of acute symptoms, a period of quiescence follows during which little or no evidence of a problem is manifest. It is during this period of subtle symptoms that treatment is often mistakenly directed toward an infectious cause. The authors describe two unusual cases, one of laryngeal and one of bronchial foreign body ingestion. They also discuss their diagnosis and management.
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PMID:Airway foreign bodies: a diagnostic challenge. 206 Nov 4

Over a period of 4 years, 14 cases of traumatic neuroma were detected in laryngoscopic biopsy specimens. The approximate incidence was 10% of biopsy specimens from this area. The most frequent symptoms in descending order of frequency, were hoarseness, dysphagia, choking spells, intermittent aphonia, and cough. Six (43%) of the 14 lesions contained mature ganglion cells. These lesions have not been reported in the pharyngeal region, and I suspect that in the past a few similar conditions have been diagnosed as ganglioneuromas. Because the lesion appears to be the cause of the symptoms and is a reactive, nonneoplastic process, accurate diagnosis and commensurate management are important.
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PMID:Pharyngeal traumatic neuromas and traumatic neuromas with mature ganglion cells (pseudoganglioneuromas). 233 5

Kaposi's sarcoma of the larynx is a rarely observed manifestation of AIDS. Possible concomitant symptoms are hoarseness up to aphonia, urge to cough or stridor. Expectoration of small parts of tissue of Kaposi's sarcoma may be an additional sign. Similar to Kaposi's sarcoma in the oral cavity Kaposi's sarcoma of the larynx is characterised by a purplish, spongy nodule. Its surface can be verrucous due to deposits of dry secretion. Local extirpation of Kaposi's sarcoma removes the laryngeal signs and symptoms.
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PMID:[Kaposi's sarcoma of the larynx]. 374 80

The use of the schwa vowel at cough offset is an automatic production that can be easily prolonged and modified as a phonation-producing device without requesting initial voluntary phonation on the part of the patient. It is presented as a clinical method that was successful for the author with two female patients presenting functional aphonia. The technique lends support to the suggestions by Aronson (1969) and Boone (1971) that the symptomatic approach can be successful with the functional aphonic patient. The clinician should be mindful of the fact that in certain cases of functional aphonia an appropriate referral might be needed to deal with emotional aspects after voice is regained.
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PMID:Cough offset schwa as a means of eliciting initial phonation in functional aphonia: two case reports. 685 53

The clinical, radiographic, gross pathologic, and histologic findings in 4 dogs with primary laryngeal neoplasia and 1 dog with secondary laryngeal neoplasia were reviewed. The clinical and radiographic findings were compared with those for proliferative inflammatory laryngeal conditions, since such conditions pose a problem in differential diagnosis. The most common clinical sign was hoarse bark or loss of voice, with subsequent onset of exertional dyspnea and cough.
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PMID:Neoplasia of the larynx in the dog. 706 4

A 37-year-old male non-smoker developed rapidly severe respiratory disease after a 3-hour exposure to hydrobromic acid fumes. An upper airway syndrome ensued with anosmia and aphonia as well as non-specific bronchial hyperreactivity, obstructive bronchiolitis (which led to a persistent respiratory volume of about 20% of the normal level with exercise-induced dyspnea) and obstructive bronchiolitis. Lung transplantation is currently being considered. When inhaled at irritant concentrations, certain toxic gases, such as chlorine, can lead to reflex apnea via laryngeal nerve reaction, limiting gas penetration into the bronchial tree. Other gases are cell toxins and can enter the deeper part of the lung before provoking irritating cough. This is what occurred for our patient who continued work in the polluted atmosphere until his severe cough obliged him to leave his job. This case is an example of cellular toxicity resulting from atmospheric gas fumes at low weakly-irritative concentrations, explaining the insidious nature of disease onset.
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PMID:[Reactive airway dysfunction syndrome and bronchiolitis obliterans after exposure to acid vapors]. 961 29

A 6-year-review of patients who presented with recurrent respiratory papillomatosis (RRP) to our hospital from January 1996 to December 2001 was carried out. Ten cases were identified, of which six were juvenile-onset RRP. Hoarseness was the most common symptom, noted in nine (90%) patients. Other clinical presentations included cough, stridor and aphonia. All patients had glottic papillomas; two had multiple sites of involvement. One patient underwent a tracheostomy that revealed papillomas over the trachea, bronchus and lung parenchyma. Half of the patients were Chinese. Of the six cases of juvenile-onset RRP, three patients were Malay, two Chinese and one Indian. Three Chinese and one German patient had adult-onset RRP. Among the juvenile-onset RRP cases, the mean age at presentation was 2 years, while for adult-onset RRP, it was 42 years. Juvenile-onset RRP was more common in females. There were more papillomas over more sites in patients with juvenile-onset RRP than with adult-onset disease. Subglottic involvement was noted in the juvenile-onset RRP cases. All patients were treated with CO2 laser therapy, but there was complete remission of the papillomas in only two cases.
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PMID:Recurrent respiratory papillomatosis. 1273 96

The impact of sustained inhaled corticosteroid (ICS) therapy on the larynx and pharynx was assessed using a prospective, cross-sectional, and investigator-blinded study conducted at the University Hospital Aintree, Liverpool, UK. Forty-six adults recruited from two local general practices and from general ENT clinics at our University hospital were investigated for the study. Patients were allocated to three groups according to ICS use. Laryngeal effects were measured by correlating the results of a vocal performance questionnaire, a respiratory symptom questionnaire, and measurements obtained by computerized speech analysis. Sustained vowels and connected speech were analyzed in normal and asthmatic subjects. Acoustic analysis was correlated with cellular markers of inflammation after biopsy. Regular ICS users had significantly more pharyngeal inflammation and throat discomfort (P<0.0001). Vocal performance was also worse in this group (P<0.0001). They were more likely to have hoarseness, weakness of voice, aphonia, sore throat, throat irritation, and cough (P<0.0001). All these variables were directly related to one another (P<0.0001). Multiple linear regression analysis showed that jitter was a good objective measure of hoarseness (P<0.05). Regular ICS users were significantly more likely to have abnormal jitter, shimmer, and closed-phase quotient scores (P<0.0001). There was no difference between the groups in the observed parameters of inflammation (P>0.01). A higher pharyngitis score did not correlate with any of the histological markers of inflammation (P>0.01). Local side effects are more common in asthmatics that use ICS regularly. Measures of laryngeal function are significantly worse in regular ICS users. However, histological markers and oropharyngeal redness are not reliable measures of inflammation.
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PMID:Acoustic analysis in asthmatics and the influence of inhaled corticosteroid therapy. 1834 71

Humans are the only species known to use whispering for communication, and humans are also the only species known to suffer from functional (psychological) aphonia, a condition in which only whispered and not vocalized speech can be produced. Thus, whispering is uniquely a human function and psychological aphonia is uniquely a human dysfunction; both can be considered to result from human evolution. We hypothesize that the human brain has developed one or more identifiable switching mechanisms that overlay whispering onto the mechanisms of normal speech production. Thus, for whispering the speech production system operates as for normal speech production, but the switch to whispering activates the laryngeal abductor muscle (and possibly the inferior pharyngeal constrictor) so that the larynx does not completely adduct and turbulence noise is produced at the larynx. We hypothesize that psychological aphonia results from involuntary or subconscious activation of this switching mechanism. Preliminary research leads us to hypothesize that there are two switching mechanisms. This research used functional magnetic-resonance imaging to contrast brain activity for both normal speech and whispering (versus silence) for normally phonic subjects in an imagined social situation. One pattern of results involved a decrease of overall activity for whispering, with possible activation of the corpus callosum, and possible crossover of the main locus of activation from the dominant to the nondominant side. The other involved increased overall activity for whispering versus normal voice, accompanied by an increase of activity in the frontal cortex. More participants exhibited the former pattern than the latter one. These results may be related to the fact that there are actually two types of psychological aphonia, one that occurs after bouts of severe coughing associated with lower-respiratory disorders and the other due to purely psychological factors. We hypothesize that these are associated with the two different switching mechanisms, an upper one associated with the conscious brain and a lower one associated with more basic functions such as protecting the vocal folds. Understanding brain mechanisms for voluntary whispering and relating them to the occurrence of dysphonia has obvious implications for improving clinical assessment and treatment of aphonia, and would also contribute to improved understanding of human function in general.
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PMID:An fMRI study of whispering: the role of human evolution in psychological dysphonia. 2148 34


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