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Can Arnold's reflex cause chronic irritating cough for a year?

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Practicing since : 1991
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Can Ear-cough (Arnold's) reflex create a chronic irritating cough for nearly a year? I have had a cough for this long. If. Use a q-tip in my right ear, it has always made me cough my entire life. When I move my throat or tongue in a certain position it can start the coughing as well. Cleveland clinic has put me thru test after test and nothing has turned up. The cough feels like it is generating from upper throat area
Posted Fri, 31 Jan 2014 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. The Ear-Cough reflex (related to the Arnold's / Aldermann's nerve) is a common source of coughing especially with the use of a q-tip the sensitive ear. Sometimes it is bilateral. 2. The Arnold's / Aldermann's nerve also receives fibers from the Glossspharyngeal (Ninth Cranial Nerve) which supplies sensation to most of the upper throat including the posterior third of the tongue. Hence these areas may be trigger points for your cough. 3. The question now arises as to why you have this increased sensitivity since a year. The possibilities are stimulation of the phrenic nerve in the chest following the drainage of a mediastinal cyst or some form of neuropathy. Have you had any Nerve Conduction Studies (NCS)? 4. Guaifenesin is an expectorant while Codeine supreses the cough centers in the brain. You may try a cough suppressant containing Guaifenesin and Dextromethorphan or Levodropropizine. This will help avoid the side effects of long term use of Codeine. I hope I have answered your query. If you have any further questions I will be available to answer them. Regards.
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Follow-up: Can Arnold's reflex cause chronic irritating cough for a year? 3 hours later
They drained the cyst hoping to solve the coughing. Do you think a ncs study could give me some answers? Could the ear cough cause a terrible coughing problem for nearly a year?
 
 
Answered by Dr. Sumit Bhatti 19 hours later
Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. Was the material drained form the cyst examined? If so, what was the report? 2. NCS may help identify any neuropathy. Which tests have been conducted at the Cleveland Clinic and what were the results? 3. It is less likely that an ear-cough reflex that was present earlier has now been causing a year long persistent cough, unless it was altered by some other pathology. 4. The cyst drainage procedure may have sensitized an ear-cardiac cough reflex or some rare, obscure throat or laryngeal reflex. I hope I have answered your query. If you have any further questions I will be available to answer them. Regards.
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