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October 1, 2020

Otolaryngologic Management of Chronic Cough in School-aged Children: A Review

Author Affiliations
  • 1Division of Pediatric Otolaryngology–Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
  • 2Department of Otolaryngology–Head and Neck Surgery, Cleveland Clinic, Cleveland, Ohio
  • 3Section Editor, JAMA Otolaryngology–Head & Neck Surgery
  • 4Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
JAMA Otolaryngol Head Neck Surg. Published online October 1, 2020. doi:10.1001/jamaoto.2020.2945

Importance  The causes of pediatric chronic cough are numerous and span across several medical subspecialties. In addition to the vast array of underlying causes, there are also several different ways to approach and evaluate chronic cough. Given the frequency with which children present to otolaryngology clinics with this problem, a review of common otolaryngologic causes and an algorithm for evaluation and treatment can be beneficial.

Observations  The primary 3 causes of pediatric chronic cough presenting to an otolaryngologist include infectious causes, reflux, and airway hyperreactivity. In these cases and other instances of specific cough, treatment should be directed at the underlying cause—which may include supportive care, antibiotics, antireflux medication, bronchodilators, inhaled steroids, or other intervention. Patients with nonspecific cough should be treated according to pediatric-specific cough algorithms.

Conclusions and Relevance  Appropriate workup and treatment of chronic cough can lead to higher cure rates, shorter cough duration, and improved quality of life for both patients and caregivers. A systematic approach using cough algorithms can help otolaryngologists effectively manage this common yet complex problem.

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