Table 1. Reported association between eosinophilic airway disease variants and chronic aerodigestive symptoms Table 1. Reported association between eosinophilic airway disease variants and chronic aerodigestive symptoms Table 1. Reported association between eosinophilic airway disease variants and chronic aerodigestive symptoms Table 1. Reported association between eosinophilic airway disease variants and chronic aerodigestive symptoms
Chronic cough Vocal symptoms Sensory symptoms (globus, tickle, catarrh sensation, urge to clear throat)
Nasal allergy
Numerous studies identify chronic cough as a primary symptom of AR/ACRS[57] [24] [58] [38] [59] [60] [29]
AR patients show subjective and objective derangements of voice quality. VHI scores show increase, while VS parameters do not change with the severity of AR.[61] Mean VHI score (p=0.001) were significantly higher in the allergic rhinitis group than in controls.[62] Patients with either AR or NAR had higher odds of dysphonia (odds ratio, 4.22; 95% confidence interval, 1.03 to 17.32) when confounding variables such as asthma, inhaled steroid use, and gastroesophageal reflux are controlled for,.[47] In a cohort with non-structural dysphonia, AR was detected at three times the rate of LPR.[35] [2]Both subjective and objective voice parameters were impaired in AR patients during pollen season, and in both measures this improved to near control levels after treatment [63] Results showed that in singers with AR both nasal (TNS of 4.0 ± 2.4 vs. 0.0 ± 0.0, p < 0.05) and laryngeal complaints (TLS of 1.4 ± 1.1 vs. 0.0 ± 0.2, p < 0.05) were induced at 3 min after the provocation. The induced laryngeal complaints were the feeling of laryngeal irritation, secretions and globus. [64] Results showed that in singers with AR both nasal (TNS of 4.0 ± 2.4 vs. 0.0 ± 0.0, p < 0.05) and laryngeal complaints (TLS of 1.4 ± 1.1 vs. 0.0 ± 0.2, p < 0.05) were induced at 3 min after the provocation. The induced laryngeal complaints were the feeling of laryngeal irritation, secretions and globus. [64] Dysphonia, frequent throat cleaning, and a globus sensation are common presentations of LPR and allergic rhinitis/laryngitis. and allergic rhinitis/laryngitis. [17] Subjective sensory symptoms of itch, irritation, mucus sticking in the throat are reported in 33-82% of patients with allergic rhinitis[36] In patients with birch pollinosis AR, 55% reported laryngeal symptoms such as cough, itch and globus. [65]
Lower airway allergy
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In asthmatic patients, maximum phonation time, frequency, and amplitude perturbation parameters were impaired, but the vital capacity and the duration of illness did not correlate with these findings.[66] [2]Values for F0, jitter, and shimmer were very similar between asthmatics and non-asthmatics, but there were statistically significant differences in values for harshness, hoarseness, NNE, S/Z ratio (all p 0.01), and breathiness (p = 0.015). Findings suggest that lower airway diseases such as asthma can impair phonation. [67]. Dysphonia is significantly more prevalent in patients with asthma compared to controls.[68] [2]Compared with non-asthma participants, asthma patients who had not taken asthma medication recently showed a higher AOR (1.62; 95% CI = 1.0–2.42) for dysphonia, and asthma patients who had taken asthma medication recently showed the highest adjusted odds ratio for dysphonia (AOR = 1.97; 95% confidence interval, CI = 1.28–3.02, P = 0.001). [69] Vocal morbidity is common in patients with asthma, and should not be immediately attributed to steroid-related candidiasis.[5] Laryngeal hypersensitivity and impaired voice measures were common in severe asthma.[70] Laryngeal sensory symptoms in patients with classical asthma (CA) or cough predominant asthma (CPA) were reported as follows CA: Itchy throat 44% Abnormal sensations 30% recurrent throat clearing 27% sensation of mucus in the throat 30.2% CPA: Itchy throat 56.5%, abnormal sensations in the throat 30%, recurrent throat clearing 32.5%, sensation of mucus in the throat 31.5% [33] Both laryngeal allergy and AC are associated with persistent dry cough, globus, atopic factors, the absence of bronchial hyperresponsiveness, and are responsive to antihistamines. [71]
## Cough related data was omitted in the case of Lower Airway Allergy VHI: Vocal handicap index VS: Vocal stroboscopy ## Cough related data was omitted in the case of Lower Airway Allergy VHI: Vocal handicap index VS: Vocal stroboscopy ## Cough related data was omitted in the case of Lower Airway Allergy VHI: Vocal handicap index VS: Vocal stroboscopy ## Cough related data was omitted in the case of Lower Airway Allergy VHI: Vocal handicap index VS: Vocal stroboscopy