The use of botulinum toxin injection as a new treatment for chronic (neurogenic) cough is new and novel. In an article by Sasieta and colleagues1 in this issue of JAMA Otolaryngology—Head & Neck Surgery, 22 patients whose chronic coughing had been repeatedly evaluated and treated for many years without benefit received 31 distinct injections of very large doses of botulinum toxin type A (BtxA) into each thyroarytenoid muscle. In this retrospective study, response to treatment was assessed via telephone follow-up using patient self-reporting of percent improvement of cough at 1 and 2 months. The primary outcome of treatment success was defined as a 50% or greater reduction in the patient’s subjective perception or assessment of their cough severity.
Bastian RW. Diabolical Coughing—Prima Facie Protocols for Diagnosis and Treatment of Medically Jaded Patients. JAMA Otolaryngol Head Neck Surg. 2016;142(9):889-890. doi:10.1001/jamaoto.2016.0973