Table 4.
Chronic inflammation—chronic laryngitis (CL) | Functional throat disorders (FTD) | |||||
Common pathophysiology | Chronic non-eosinophilic inflammation of the ADT | Chronic eosinophilic inflammation of the ADT | Abnormal sensory or motor function within the ADT or components, without clear organic disease correlates | |||
Aetiology | GORD | Aeorsolised irritants | Voice behaviours | Aerosolised allergens | Aerodigestive sensory/reflex dysfunction | Aerodigestive motor dysfunction |
Diagnoses | LPR, EER, RL | OL, WAL, WUACS, WAILS, OCS | VA, VTL, SD, MTD | LA, AL | ILS, LH, SLN, LD, CHS, ICC, RCC, GP | LD, MTD, FD, LHS, UESD, CPS, VCD, PVFM, STD |
Reported symptoms | ||||||
Cough | ++ | ++ | ++ | ++ | ++ | ++ |
Dysphonia | ++ | ++ | +++ | ++ | ++ | ++ |
Dysphagia | + | + | + | + | ++ | +++ |
Globus | ++ | + | + | + | +++ | ++ |
Paraesthesia | ++ | ++ | ++ | ++ | + | + |
Throat clearing | ++ | ++ | ++ | +++ | ++ | ++ |
Reported nasoendoscopic findings | ||||||
Features of mucosal inflammation | ++ | ++ | ++ | ++ | ++ | ++ |
Vocal cord dysfunction | + | + | ++ | + | ++ | ++ |
Abnormal muscle tone or coordination | ++ | ++ | +++ | ++ | +++ | +++ |
Sensitive and specific clinical findings or biochemical markers | No | No | No | No | No | No |
AL, allergic laryngitis; CHS, cough hypersensitivity syndromes; CPS, cricopharyngeal spasm; EER, extraesophageal reflux; FD, functional dysphonia; GORD, gastro-oesophageal reflux disease; GP, Globus pharyngeus; ICC, idiopathic chronic cough; ILS, irritable larynx syndrome; LA, laryngeal allergy; LD, laryngeal dysfunction; LH, laryngeal hypersensitivity; LHS, laryngeal hyperfunction syndromes; LPR, laryngopharyngeal reflux; MTD, muscle tension dysphonia; OCS, occupational cough syndrome; OL, occupational laryngitis; PVFM, Paradoxical vocal fold movement (excluding inducible laryngeal obstruction); RCC, refractory chronic cough; RL, reflux laryngitis; SD, Singers dysphonia; SLN, superior laryngeal nerve neuropathy; STD, supraglottic tension dysphonia ; UESD, upper oesophageal sphincter dysfunction; VA, vocal abuse; VCD, vocal cord dysfunction; VTL, vocal tension laryngitis; WAILS, Workplace associated irritable larynx syndrome OCS ; WAL, workplace-associated laryngitis; WUACS, Workplace upper airway cough syndrome .