Upper airway disorders within adult respiratory services – evidence and research

A summary of evidence and research relating to upper airway disorders within adult respiratory services and the role of speech and language therapy.

Last updated: November 2021

Introduction

Research relating to upper airway disorders remains in the embryonic state. Understanding on the mechanistic drivers, epidemiological profiles, optimal evaluation techniques and targeted treatment modalities remain largely unknown. Development of standardised assessment and treatment algorithms is therefore limited and based on clinical consensus rather than quality evidence.

The speech and language therapy workforce can make a significant contribution in developing a more robust evidence base and improve the quality of care provided. Collaborative working with MDT colleagues to support and lead research agendas is recommended. Research and innovation within the field should focus on the benefit speech and language therapy can make to the management of upper airway disorders.

SLTs should be active in continually appraising the impact of the role of speech and language therapy in upper airway disorders within respiratory services. Regular audits, service evaluation or quality improvement projects are recommended.

Systematic reviews

Molassiotis, A., Bryan, G., Caress, A., Bailey, C., and Smith, J. (2010). Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature. Respiratory Medicine CME, 3(4), 199-206.

Patel RR, Venediktov R, Schooling T, Wang B. Evidence-based systematic review: effects of speech-language pathology treatment for individuals with paradoxical vocal fold motion. American journal of speech-language pathology. 2015 Aug;24(3):566-84.

Song WJ, Chang YS, Faruqi S, Kim JY, Kang MG, Kim S, Jo EJ, Kim MH, Plevkova J, Park HW, Cho SH. The global epidemiology of chronic cough in adults: a systematic review and meta-analysis. European Respiratory Journal. 2015 May 1;45(5):1479-81.

Cochrane reviews

Cochrane Reviews are systematic reviews of primary research in human health care and health policy, internationally recognised as the highest standard in evidence-based health care. Search the Cochrane Database of Systematic Reviews.

Slinger, C., Mehdi, S.B., Milan, S.J., Dodd, S., Matthews, J., Vyas, A. and Marsden, P,A. (2019) Speech and language therapy for management of chronic cough. Cochrane Database of Systematic Reviews. Issue 7. CD013067

Key texts

Chamberlain MS, Garrod R, Clark L, Douiri A, Parker SM, Ellis J, Fowler SJ, Ludlow S, Hull JH, Chung KF, Lee KK. Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial. Thorax. 2017 Feb;72(2):129.

Christensen PM, Heimdal JH, Christopher KL, Bucca C, Cantarella G, Friedrich G, Halvorsen T, Herth F, Jung H, Morris MJ, Remacle M. ERS/ELS/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions. European Respiratory Review. 2015 Sep 1;24(137):445-50.

Fowler SJ, Thurston A, Chesworth B, Cheng V, Constantinou P, Vyas A, Lillie S, Haines J. The VCDQ–a Questionnaire for symptom monitoring in vocal cord dysfunction. Clinical & Experimental Allergy. 2015 Sep;45(9):1406-11.

Haines J, Hull JH, Fowler SJ. Clinical presentation, assessment, and management of inducible laryngeal obstruction. Current opinion in otolaryngology & head and neck surgery. 2018 Jun 1;26(3):174-9.

Halvorsen T, Walsted ES, Bucca C, Bush A, Cantarella G, Friedrich G, Herth FJ, Hull JH, Jung H, Maat R, Nordang L. Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement. European Respiratory Journal. 2017 Sep 1;50(3).

Hull JH, Backer V, Gibson PG, Fowler SJ. Laryngeal dysfunction: assessment and management for the clinician. American journal of respiratory and critical care medicine. 2016 Nov 1;194(9):1062-72.

Morice AH, Millqvist E, Bieksiene K, Birring SS, Dicpinigaitis P, Ribas CD, Boon MH, Kantar A, Lai K, McGarvey L, Rigau D. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. European Respiratory Journal. 2020 Jan 1;55(1).

Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL. Efficacy of speech pathology management for chronic cough: a randomised placebo controlled trial of treatment efficacy. Thorax. 2006 Dec 1;61(12):1065-9.

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