Botox for Chronic Cough

There have been a few reports that discuss the use of botox to achieve significant improvement, if not cure, in adult patients with a chronic cough due to sensory neuropathy. In one report, researchers presented 4 case studies in which cough relief occurred after a median of 7 injections with a mean dose of 4.0 Units per treatment session for a mean duration of 25.7 months. In another report, Mayo researchers performed botox injection in 22 patients among which 50% reported improvement in the cough by at least 50%.

To watch a video of how the botox is injected into the voicebox to treat chronic cough, click here or watch below (the procedure is the same as that performed for spasmodic dysphonia).

Of note, the first to report on use of botox for chronic cough was published in 2007 in ENT Journal and was performed on kids. Click here to read that report.

I tend to use botox as a last resort when other medical management strategies have failed. Hidden triggers of cough including reflux, allergies, and asthma need to be addressed prior to consideration of botox. Often, I'll give a trial of neuropathic medications if laryngeal sensory neuropathy is suspected.

To read more about chronic cough, click here.

Botox is performed by Dr. Chang every Friday afternoon for spasmodic dysphonia, laryngospasm, as well as chronic cough! We also use botox for migraines, facial wrinkles, and torticollis.

References:
Botulinum toxin A: a novel adjunct treatment for debilitating habit cough in children. Ear Nose Throat J. 2007 Sep;86(9):570-2.

Use of botulinum toxin type A for chronic cough: a neuropathic model. Arch Otolaryngol Head Neck Surg. 2010 May;136(5):447-52. doi: 10.1001/archoto.2010.59.

Bilateral Thyroarytenoid Botulinum Toxin Type A Injection for the Treatment of Refractory Chronic Cough. JAMA Otolaryngology - Head & Neck Surgery 2016 Jun 30;PMID: 27367917