A Comparison of Therapy Adherence for Vocal Fold Atrophy and Chronic Cough.

Introduction: Therapy is a common treatment for dysphonia attributable to vocal fold atrophy and chronic cough with the goal of decreasing procedural intervention. We compared the rates of therapy adherence and the factors associated with therapy adherence across groups.

Methods: Retrospective chart review at a single institution since 2019. Groups were compared with chi-square and relative risk.

Results: Across both diagnoses, 263 patients were identified; 131 (49.8%) with vocal fold atrophy and 132 (50.2%) with chronic cough. 173 patients (66%) were referred to speech therapy (81/131 atrophy, 61.8%; 91/132 cough, 69.7%; p = 0.207). Patients were evaluated in a multidisciplinary setting 30.1% of the time. Among those referred to therapy, patients who underwent their initial evaluation the same day within a multidisciplinary clinic were more likely to complete their course (30.7% vs 10.7%, p = 0.001). This association held on multivariable analysis (relative risk [RR] 2.39, 95% confidence interval 1.13-5.07, p = 0.02). Patients with atrophy and cough had similar therapy completion rates (22.2% vs 11.9%, p = 0.07). Male patients were more likely to complete therapy on multivariable analysis (RR 2.35, 1.16-4.47, p = 0.017). Patients who completed a procedure prior to therapy were not more likely to complete their course (p = 0.52).

Conclusions: Multidisciplinary clinic with a speech pathologist and laryngologist is associated with an increased rate of therapy adherence in both vocal fold atrophy and chronic cough, regardless of diagnosis. Pre-therapy procedural interventions were not associated with increased therapy adherence.

Level of evidence: 3 Laryngoscope, 2025.