I've had chronic throat clearing for nearly 40 years. resulting as best as I can recall from a flu or cold back then. It is nearly debilitating at times and affects my ability to teach, lecture, public speaking, etc. I've tried reflux and post-nasal meds as well as gabapentin and other meds to no avail. It sometimes seems to come out of nowhere. It has also become psychosomatically induced (if that's the right term) - even thinking about it causes the need to clear my throat to start.

Some foods can affect it: ice cream sometimes, coffee sometimes (which I usually limit to less than a cup or so a day). But I've tried a low-acid diet, eliminating citrus, caffeine, vinegar, etc., which didn't substantially help.

When it gets really bad, I resort to prednisone. But obviously I can't do that on a regular basis.

My ENT says Botox is not recommended for this because it can affect the vocal chords. (I brought up Botox after my own research.)

I really need suggestions. I'm also interested in trying hypnosis to address the psychosomatic aspect.

Thanks!