A rare cause of chronic cough

[...]chronic cough guidelines suggest further evaluation in patients whose cough persists despite adequate treatment with inhaled corticosteroids.1 The clear association between touching the neck and cough resulted in the decision to perform imaging of the neck as next diagnostic step. Cough as the first presentation of a paraganglioma is rare.2 3 Concerning the mechanism of cough, we hypothesise that the mass causes mechanical stimulation of small branches of the vagus nerve, similar to the Arnold’s nerve ear-cough reflex, where manipulation of the external auditory canal can activate the auricular branch of the vagus nerve and evoke cough.4 Resection is the treatment of choice for secreting or locally symptomatic tumours. An update and systematic review on drug therapies for the treatment of refractory chronic cough.