Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. The Ear-Cough reflex (related to the Arnold's / Aldermann's nerve) is a common source of coughing especially with the use of a q-tip the sensitive ear. Sometimes it is bilateral. 2. The Arnold's / Aldermann's nerve also receives fibers from the Glossspharyngeal (Ninth Cranial Nerve) which supplies sensation to most of the upper throat including the posterior third of the tongue. Hence these areas may be trigger points for your cough. 3. The question now arises as to why you have this increased sensitivity since a year. The possibilities are stimulation of the phrenic nerve in the chest following the drainage of a mediastinal cyst or some form of neuropathy. Have you had any Nerve Conduction Studies (NCS)? 4. Guaifenesin is an expectorant while Codeine supreses the cough centers in the brain. You may try a cough suppressant containing Guaifenesin and Dextromethorphan or Levodropropizine. This will help avoid the side effects of long term use of Codeine. I hope I have answered your query. If you have any further questions I will be available to answer them. Regards.

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Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. Was the material drained form the cyst examined? If so, what was the report? 2. NCS may help identify any neuropathy. Which tests have been conducted at the Cleveland Clinic and what were the results? 3. It is less likely that an ear-cough reflex that was present earlier has now been causing a year long persistent cough, unless it was altered by some other pathology. 4. The cyst drainage procedure may have sensitized an ear-cardiac cough reflex or some rare, obscure throat or laryngeal reflex. I hope I have answered your query. If you have any further questions I will be available to answer them. Regards.

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