Aerodigestive Approach to Chronic Cough in Children

Abstract

Purpose of review: Chronic cough is the most common presenting complaint in a pediatric aerodigestive clinic. The etiology of chronic cough is varied and often includes more than one organ system. This review aims to summarize the current literature for a multidisciplinary approach when evaluating a child with chronic cough.

Recent findings: There is very little medical literature focused on a multidisciplinary approach to chronic cough. In the limited data available, multidisciplinary clinics have been shown to be more cost-efficient for the families of children with complex medical problems, and also increase the likelihood of successfully obtaining a diagnosis.

Summary: There is no consensus in the literature on how to work-up a child with chronic cough presenting to an aerodigestive clinic. Current studies from these clinics have shown improved outcomes related to cost-effectiveness and identifying definitive diagnoses. Future studies evaluating clinical outcomes are necessary to help delineate the utility of testing routinely performed, and to demonstrate the impact of interventions from each specialty on quality of life and specific functional outcome measures.

Keywords: aerodigestive; chronic cough; multidisciplinary clinic; pediatrics.

Figure 1.

Conceptual overview of aerodigestive program core components involved in a patient encounter. General aspects to streamline centralized patient flow consist of 1) key providers including a care coordinator; 2) sharing of patient clinical information before/during clinic visits; 3) multidisciplinary discussion to develop a comprehensive plan that is then shared with the patient/family; and then 4) planning future steps including objective testing, procedures and follow up visits. Actual implementation of these core components will vary between aerodigestive programs based on local and institutional resources.