Mapping Extrapulmonary Cough Receptors in the Larynx and Pharynx in Healthy Individuals: A Scoping Review


Objective: to identify and describe extrapulmonary cough receptors located in healthy individuals’ larynges and pharynges and the types of stimuli to which they are sensitive. Data Sources: the search was performed electronically in the LILACS, Scopus, Web of Science, Embase, PubMed/MEDLINE, and Cochrane Library databases, manually in gray literature (Google Scholar, MedRxiv, and ProQuest), and by mapping citations and consulting experts. Review Methods: this scoping review’s protocol was registered in the Open Science Framework. It followed the Joanna Briggs Institute and was described in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Extension for Scoping Reviews. The review included studies describing laryngeal and pharyngeal cough receptors in healthy individuals. The data were analyzed descriptively. Results: the search found 12 studies on extrapulmonary cough receptors, all describing laryngeal and seven of them also pharyngeal ones. Only rapidly adapting receptors (RARs) with myelinated fibers were reported in both regions, responding predominantly to mechanical stimuli. The locations of the receptors, when described, are not uniform, with epithelium and mucosa being possible sites. Clinically,

understanding how these receptors function allows correlating sensory alterations with conditions such as chronic cough, laryngeal dysfunctions, and voice disorders related to laryngeal hypersensitivity or hypoactivity. Thus, comprehending the role and sensitivity of cough receptors in the larynx and nasopharynx provides valuable neurophysiological foundations for the assessment, prevention, and rehabilitation of vocal function. Conclusion: data on the location of extrapulmonary cough receptors in healthy individuals are heterogeneous. RARs that respond mainly to mechanical stimuli predominate in these regions and conduct stimuli to the nerve centers through myelinated fibers to trigger cough.

Keywords: Cough; Cough Receptors; Cough Reflex Arc; Larynx; Pharynx.

Luciane
Carolina
Rodrigo
Vanessa
Mara
Teixeira Soares
Silverio
Dornelas
Veis Ribeiro
Behlau