Fundoplication in Chronic Intractable Cough

Faruqi S, Sedman P, Jackson W, Molyneux I, Morice A. Cough. 2012;8:3.

OBJECTIVES: Airway reflux is a common cause of chronic cough and this is often refractory to medical therapy. Surgery in the form of Nissen fundoplication has been highly successful in the treatment of the classic reflux symptoms of heartburn and dyspepsia. There is a paucity of data regarding response to fundoplication in patients presenting with chronic cough.

RESULTS: Forty seven patients underwent fundoplication. The average duration of pre-operative cough was 8 years. Gastrointestinal symptoms were present in the majority. In 30 (64%) patients a positive response to treatment was recorded. Mild dysphagia or bloating was seen in 18 patients following surgery. Four patients needed repeat surgical intervention for modification of fundoplication. One patient developed aspiration pneumonia eight weeks following surgery and died of a myocardial infarction. Two thirds of patients with persisting cough had evidence of airway reflux on pharyngeal pH monitoring.

CONCLUSION: In these patients with intractable cough a long term response rate of 63% represents a useful therapeutic option. Treatment failure is more frequent than for classic peptic symptoms and may be related to persistent gaseous reflux.

 

Topics: pH monitoring, ENT, Antireflux Surgery, 2012

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