이비인후과 영역에서 만성 기침을 유발하는 질환의 분석

Background and Objectives: Cough is one of the most common symptoms for which adult patients seek medical attention. Two diseases of pathologic triad of chronic cough, post-nasal drip syndrome and reflux disease, are categorized into otorhinolaryngologic field. This study is designed to find out possible causes of cough in otorhinolaryngologic field and to inspire the need for scrupulous examination on chronic cough patients. Materials and Methods: All of 554 patients refered to the department of otorhinolaryngology for chronic cough lasting over 3 weeks were reviewed retrospectively. With excluding smokers and patients in whom specific causative disorders had been confirmed at other departments or required surgical management, otorhinolaryngologic causes were evaluated on 123 patients. The presumptive diagnoses were determined from clinical, laboratory and radiological findings. And the final diagnosis was determined from trials of therapeutics. Subjective discomfort induced by cough was measured with visual analogue scale (VAS) and compared before and after treatment. Results: The three most important causative diseases for chronic cough on otorhinolaryngolgic field were chronic rhinosinusitis (60.2%), allergic rhinitis (52.8%) and laryngopharyngeal reflux (39.8%). In 47 patients (38.2%), two or more causes were found. The success rate of treatment was 89.3%. Subjective discomfort on VAS has improved from 6.6 to 1.2 after treatment. Conclusion: This study revealed that 22.2% of chronic cough patients had otorhinolaryngologic causes and most of them could be controlled with proper diagnosis and management. Therefore, otorhinolaryngologists should keep all possible causes for cough in mind and carefully evaluate patients of chronic cough. (J Clinical Otolaryngol 2009;20:229-234)