Chronic cough (TC) is that cough that persists for more than 8 weeks and affects between 7% and 10% of the population, especially women in the 5th decade. The mechanism of CT is due to a reflex arc where the peripheral receptors are located in the larynx, tracheo-bronchial tree and esophagus and, to a lesser extent, in the middle ear and pericardium.
If we treat the inflammation that originates in those places theoretically we can cancel the afferent path of the reflex arc. International experience maintains that CT scanning is not so easy for three reasons: the level of deepening of the diagnosis of inflammation in the periphery of the reflex arc, the possibility of several simultaneous origins of the start of stimulation and the acquired hypersensitivity at the level of the center of cough in the central nervous system, which can cause even small peripheral stimuli to produce a cough. Several stimuli from different places can develop at the central level a suprastimulation by convergence of the same that, over time, can alter the cough reflex chronically.
CT is usually associated with the diagnostic triad: eosinophilic bronchial inflammation (EIB), gastroesophageal reflux (GER), and upper airway disease, and will usually respond to specific treatment. However, the total cough solution is rare when treated according to this triad, except in the IBE, when corticosteroids are prescribed. Therefore, the Chronic Cough Syndrome is increasingly valued as a Hypersensitivity Syndrome somewhere in the reflex arc. This hypersensitivity can be measured in the laboratory but it has been shown in some tosedores that this test remains abnormal despite the fact that CT improves when treating central hypersensitivity; and this happens with a frequency close to 40% of TC. This type of cough is then called refractory or unexplained, forcing a laryngeal rehabilitation (hence the place with the greatest number of receptors) to begin and using drugs that act at the neurological level.