Cough is one of the most common reasons for health care visits. This article seeks to illustrate the classification, appropriate workup, and management of acute and subacute cough. It highlights etiologies such as bronchitis, pneumonia, and exacerbation of heart failure and asthma. There is an emphasis placed on potentially life-threatening pathologies associated with cough and how to appropriate triage cough severity in an emergency setting. The pathophysiology of cough and how it may lead to severe barotraumatic complications such as pneumothorax and Mallory Weiss tears is discussed.

Obstructive eustachian tube dysfunction (ETD) contributes to a spectrum of middle ear disorders, including otitis media with effusion (OME), tympanic membrane retraction, and barochallenge-induced symptoms. This review summarizes evidence-based treatment outcomes, focusing on efficacy derived from systematic reviews and safety from additional sources. Medical management has no proven benefits for obstructive ETD. Tympanostomy tubes and adenoidectomy demonstrate age-specific effectiveness for pediatric OME with accepted risks. Some manifestations of ETD may benefit from balloon dilation of the eustachian tube (BDET), or sinonasal surgery, but much evidence is of low quality; indications, long-term benefits, and safety are not clearly established for BDET.

Congenital tracheal stenosis (CTS) from complete tracheal rings is a rare and potentially life-threatening condition necessitating complex multidisciplinary management. This clinical review explores the anatomic patterns of CTS and discusses diagnostic nuances, emphasizing the use of ultrasmall instrumentation to avoid mucosal trauma. We detail the historical failure of graft-based repairs and the paradigm shift brought by slide tracheoplasty. Current surgical management for long-segment and short-segment disease is discussed, emphasizing the narrowest point philosophy, 45-degree beveled incisions, and internal Grillo sutures. Finally, we address the management of technical complications and the coordinated aerodigestive model of care.

Cough pathophysiology ranges from a simple reflex to a complex neuroimmune disorder involving intricate neural circuitry, peripheral sensitization, and central plasticity. The cough reflex is governed by a complex orchestration of sensory nerves and central brain structures. Chronic cough often results from peripheral and central sensitization, leading to hypersensitivity influenced by various physiologic and environmental factors. This advanced understanding is vital for developing personalized, mechanism-directed therapies for this prevalent condition.

Cough can result from a variety of etiologies, and rare pulmonary, otolaryngologic, cardiac, neurologic, medication-related, and functional conditions are often overlooked. Pulmonary etiologies, including structural airway abnormalities, endobronchial obstruction, expiratory central airway collapse, and occupational eosinophilic bronchitis, frequently require advanced imaging and bronchoscopy for diagnosis. Otolaryngologic conditions include elongated uvula, tonsillar hypertrophy, and external auditory canal pathology, which can trigger vagally mediated cough reflexes. Obstructive sleep apnea may result in chronic cough through inflammatory and reflux-mediated mechanisms. Cardiac causes include heart failure, airway compression, and arrhythmias. Neurologic, medication-induced, and functional causes should also be considered in refractory cases.

Cough is one of the most common symptoms prompting medical consultation and represents a diagnostic challenge due to its multifactorial nature and often overlapping etiologies. This review outlines the pulmonologist's systematic approach to the evaluation and management of cough, emphasizing the importance of classifying cough as acute, subacute, or chronic to guide investigation and treatment. Overall, this article underscores the complexity of cough evaluation and the necessity of a comprehensive, patient-centered approach. This article describes the pulmonologist's approach to the diagnosis and treatment of cough and how it interplays with the otolaryngologist's evaluation. The need for an interdisciplinary approach to diagnoses and treat cough is emphasized.

This article provides a practical guide to building a multidisciplinary chronic cough clinic, a model designed to enhance clarity and efficiency in addressing a condition that is often challenging to diagnose and manage. Given that chronic cough frequently stems from overlapping causes and evaluations may be prolonged and fragmented, coordinated assessment is essential. The article highlights the value of otolaryngology and pulmonology jointly assessing patients together at the initial visit, supported by well-defined referral pathways to gastroenterology, allergy, and speech-language pathology.

Eustachian tube dysfunction (ETD) is a commonly suspected cause of aural fullness, otalgia, and hearing loss, but presentation varies among patients. In addition, these symptoms are not specific and can be indicative of other conditions. Some of these conditions are otologic in nature and can be localized to the external, middle, or inner ear. Others arise from outside the ear and can be attributed to functional, neurologic, or structural causes. While presentation may be similar to ETD, differentiation is possible with clinical history, physical examination, and objective testing such as otoscopy, tympanometry, imaging, and specialized vestibular testing.

Exercise-induced laryngeal obstruction is a multifactorial disorder involving reversible laryngeal narrowing during exercise, influenced by developmental, physiologic, psychological, and sport-specific factors. A high index of suspicion in youth with exertional dyspnea is needed, as clinical history most strongly supports the diagnosis along with pulmonary evaluation and laryngoscopy to rule out alternative or comorbid pathology. Management is multidisciplinary, with growing evidence for behavioral and physiologic interventions-including laryngeal control therapy and respiratory retraining-alongside cognitive-behavioral strategies targeting anxiety, stress, and performance demands. Collaborative care among otolaryngology, pulmonology, behavioral health, and athletic staff optimizes outcomes and supports safe return to sport.

There has been considerable growth in our knowledge of laryngeal tracheoesophageal clefts or laryngeal clefts, an anomalous communication between the airway and the esophagus. The most recent classifications separate laryngeal clefts into 4 major groups differentiated by the depth of the cleft. Presentation includes respiratory and swallowing difficulties and work up includes evaluation in and out of the operating room. Minor grade clefts may be managed in a variety of ways while higher grade clefts will require surgical intervention. A multidisciplinary team is key in all aspects of diagnosis, treatment, and long-term management.

Pediatric airway foreign bodies are common and potentially life-threatening situations. Ingestion of organic material in children under 3 is the most common clinical situation. Typical cases have a history suspicious for a sudden aspiration event supported by physical findings of wheezing or diminished breath sounds with radiological evidence of air-trapping. Rigid bronchoscopy remains the gold standard for diagnosis and treatment and providers should have a low threshold to proceed to the operating room if the clinical suspicion for aspiration is high. Computed tomography (CT) scans may be helpful to further guide decision-making in cases where there is low or intermediate suspicion.

Pediatric dynamic airway collapse is a complex condition that can impact all levels of the pediatric airway. These conditions can pose life threatening risk to pediatric patients and carry lasting impacts. While traditionally, tracheostomy has been used to address all levels of dynamic collapse, recent advances have allowed for more individualized, anatomy-specific stenting and splinting strategies for treatment. This article covers pathophysiology and the latest evidence on strategies to address nasopharyngeal, oropharyngeal, proximal trachea, and tracheobronchial dynamic collapse.

This is a clinical review article summarizing the current literature, which has studied complications from surgical intervention for obstructive Eustachian tube dysfunction, focusing primarily on balloon dilation. Clinical evidence is organized based on the mechanism of injury. Explanations are presented for how complications may have arisen, as well as strategies to avoid them, to both improve clinical outcomes and provide accurate informed consent.