Throat & Cough

The throat is a very sensitive place. It has an important job of keeping irritating particles out of the lungs and detecting when there is a problem with the airway. Cough is one of the body’s defense mechanisms for eliminating foreign material or clearing the lungs of debris.

The larynx or voice box is the “gateway” to the airway and helps in detection and protection. When the airway becomes irritated and the larynx becomes sensitive, cough can become a problem that is not helpful but instead harmful to the patient. Prolonged cough for greater than a week can be painful, can cause damage to the vocal cords, and can be a nuisance to family, friends, and coworkers.

Cough can come from a variety of problems and a thorough evaluation is necessary to determine causes and best treatment. Allergies, sinus infections, asthma, viral and bacterial infections, reflux, tumors, and throat inflammation can all cause cough. Nerve sensitivity from infection can linger and can cause cough long after an infection is gone. Fume exposure can cause airway irritability. Chronic lung disease can cause unrelenting cough that has a very different treatment. The ear, nose, and throat doctor is an important visit to evaluate the upper airway for infection, inflammation, or growths that can cause cough or throat pain.

Why Am I Coughing?

Cough is a natural reflex that is meant to clear the airway of foreign material or irritants. The airway, which includes the larynx(voice box),pharynx(throat), trachea(windpipe), bronchi (large airways going to the lungs), bronchioles (small airways going to the lungs), and alveoli (lung tissue) can be affected at any site by many things that can cause cough. The nerve that sets off the cough reflex also innervates the esophagus so problems inside the esophagus can also cause cough.

Causes of Cough

A cough may be a simple irritation of the throat, vocal cords, or airway from allergies, infection, or reflux. However, it may also be an early sign of severe disease in the throat, airways, or esophagus that needs immediate treatment. A cough lasting longer than one week should be evaluated by a physician specializing in these areas. The otolaryngologist can help the general physician or lung specialist by evaluating other areas that may be causing the cough.

Sinus drainage and allergies are a common cause of cough and chronic sinus infections may be responsible for a cough that goes on for greater than 6 weeks. Any cough lasting longer than 6 weeks is considered “chronic” and may require additional treatment. 

Frog In Your Throat

The phrase “a frog in my throat” often describes a sensation of thick mucus that can coat the vocal cords, causing a rough voice and a sensation of needing to clear the throat or cough often. Sometimes it means a sensation that there is something stuck in the throat. Many conditions can cause a sensation of mucus in the throat. Allergies, reflux, viral and bacterial infections, exposure to dust and fumes, and drying medications are some of the causes. Chronic inflammation in the sinuses, back of the nose or throat, or in the larynx can cause the normal mucus glands of the throat to increase in number and secrete more mucus. Occasionally a swallowing or neurologic problem will cause build-up of saliva and lead to this sensation of thick mucus.

A complete evaluation of the head and neck including sinuses, nose, mouth, and throat is necessary to begin on the road to a solution. Other tests such as allergy testing, reflux testing, or bloodwork for infection may be necessary to accurately diagnose what is causing this sensation. The good news is, most of the time this issue can be corrected!

Evaluation & Treatment

A cough is a very general symptom that needs a thorough evaluation of the upper and lower airways, chest, and throat. Dr. Anderson will evaluate the nose and sinuses, throat and vocal cords, and order chest imaging if necessary. She may also need to evaluate the esophagus. She will rely on other specialists such as pulmonologists, neurologists, or allergists if necessary to completely evaluate the problem. Bloodwork or x-rays may be necessary to exclude infection or other problems. Depending on the diagnosis, you may require medication, therapy, or surgery.

Throat & Cough Disorders

Chronic Cough

Cough is a natural reflex that is meant to clear the airway of foreign material or irritants. The airway, which includes the larynx(voice box), pharynx(throat), trachea(windpipe), bronchi (large airways going to the lungs), bronchioles (small airways going to the lungs), and alveoli (lung tissue) can be affected at any site by many things that can cause cough. The nerve that sets off the cough reflex also innervates the esophagus so problems inside the esophagus can also cause cough.

Chronic cough is any cough that goes on for more than 6 weeks and should be evaluated by a physician. It is important to examine all areas of the airway and swallowing passages, either with endoscopes (small cameras) or with radiographs (x-rays). Infection is a common cause of cough and can be caused by viruses or bacteria. Irritation of the airways with smoking or by frequent exposure to fumes or particulates (like asbestos, wood dust, or construction dust) is a very common cause of cough. Nerve hyperirritability may cause cough long after an infection is cleared. Tumors in the chest, lung, throat, or esophagus can cause cough. Foreign bodies, often a cause of cough in small children, can become lodged in the airways causing cough.

Sinus drainage and allergies are a common cause of cough and chronic sinus infections may be responsible for a cough that goes on for greater than 6 weeks.

Chronic Sinusitis

Chronic sinusitis is a condition that can cause laryngeal irritation by the drip of infected and inflammatory substances onto the vocal cords. Most patients with chronic sinus infections feel sinus pressure or pain, but occasionally the only presenting symptom of sinusitis is chronic cough or hoarseness with a sensation of postnasal drainage.

Treatment of chronic sinusitis varies with the severity and anatomic problems as well as the cause of the infection (bacterial or fungal). Treatment may require antibiotics, mucolytics, sinus rinses (saline or medicated rinses), balloon sinus dilation, or traditional sinus surgery.

Evaluation of the nose and sinuses for the patient with hoarseness is an important part of the visit. Allergies can also cause swelling of the lining of the nose and sinuses and may contribute to nasal polyps which can block sinuses. Allergy testing can determine if immunotherapy is an option for treatment. Immunotherapy is beneficial to the singer or speaker with hoarseness from allergies as it eliminates the need for drying antihistamines and nasal sprays.

Chronic Laryngitis

Chronic laryngitis is a condition where the vocal cords and tissue around the vocal cords are inflamed for a long period of time. Most commonly this condition is caused by smoking cigars and cigarettes. It can also be caused by exposure to fumes, such as petroleum products, aerosolized acids, bleaches, dust, and chlorine.

Often the larynx is irritable and the patient may have a cough and a rough voice. Allergies, post nasal drainage, sinusitis, reflux, viral, and bacterial infections can also cause chronic laryngitis and proper treatment can improve or restore normal vocal cord function.

Proper diagnosis of chronic laryngitis with targeted testing is important to accurately treat this condition.

Laryngeal Spasm

Laryngeal spasm is when the vocal cords narrow or close inappropriately. It can cause problems speaking or breathing, or can make a person feel like they are choking or that their “air is being cut off.” It is usually treatable with medication or therapy (or a combination). It is usually caused by an underlying medical problem in the throat or airways.

You may require medication, therapy, or a combination of the two to help with your spasm. Dr. Anderson also performs Botox injections in the clinic to treat spasm. If you are a patient that has received Botox before for spasmodic dysphonia, you will be pleased with the ease of treatment and quick office visit for your injection.