PT -期刊文章盟bir S.S. AU -更胜一筹nt, C. AU - Patel, R.B. AU - Prudon, B. AU - Murty, G.E. AU - Pavord, I.D. TI - Chronic tonsillar enlargement and cough: preliminary evidence of a novel and treatable cause of chronic cough AID - 10.1183/09031936.03.00066403 DP - 2004 Feb 01 TA - European Respiratory Journal PG - 199--201 VI - 23 IP - 2 4099 - //www.qdcxjkg.com/content/23/2/199.short 4100 - //www.qdcxjkg.com/content/23/2/199.full SO - Eur Respir J2004 Feb 01; 23 AB - Tonsillar enlargement is sometimes seen in patients with otherwise unexplained chronic cough although its significance is unclear. In this study, the authors set out to test the hypothesis that cough symptoms and cough reflex sensitivity will improve after tonsillectomy in patients with otherwise unexplained chronic cough and enlarged tonsils. Eight consecutive patients with unexplained chronic cough and enlarged tonsils were recruited from 236 patients seen in a cough clinic between 2000 and 2001. Six patients with enlarged tonsils and no cough who were undergoing tonsillectomy for other reasons were recruited as a control group. All patients rated cough severity on a cough visual analogue score (0–100 mm) and had capsaicin cough reflex sensitivity measurement twice before and again 3 months after tonsillectomy. Patients with a chronic cough had heightened cough reflex sensitivity compared with the control group at baseline. There was a significant improvement in mean cough visual analogue score 3 months after tonsillectomy in patients with chronic cough (mean difference 30 mm; 95% confidence interval of difference 8–51 mm). The geometric mean concentration of capsaicin required to cause five coughs increased from 4 to 207 µmol·L−1 after tonsillectomy in patients with chronic cough (mean difference from baseline 5.6 doubling concentrations; 95% confidence interval of difference 3.1–8.2). There was no change in cough reflex sensitivity in control patients after tonsillectomy. These preliminary findings suggest for the first time a possible role for tonsillectomy in patients with enlarged tonsils in whom other causes of cough have been ruled out. S.S. Birring is a British Lung Foundation clinical research fellow. This study was funded by the British Lung Foundation and University Hospitals of Leicester NHS Trust.