Robertson S, Young D, McGarry G W, MacKenzie K
Department of ENT Head & Neck Surgery, Glasgow Royal Infirmary, Glasgow, UK.
Clin Otolaryngol. 2008 Oct;33(5):458-61. doi: 10.1111/j.1749-4486.2008.01765.x.
To determine (i) the prevalence of unsuspected upper aerodigestive tract disease in snorers, (ii) the diagnostic yield of routine flexible endoscopy and (iii) the relationship between symptoms of upper aerodigestive tract disease and examination findings in snorers.
Prospective analytical cohort study.
Snoring clinic in Secondary Care Otolaryngology centre.
Ninety-three patients referred with disruptive snoring.
A structured history of upper aerodigestive tract symptoms was obtained by clinic interview. All patients underwent detailed ENT examination. Univariate analysis was undertaken on data collected.
The prevalence of oropharyngeal and laryngeal pathology in the cohort was 3%. No unsuspected upper aerodigestive tract pathology was found on routine flexible endoscopy. A history of Hard Nasal Symptoms was an accurate predictor of underlying nasal pathology.
The authors propose that the detailed examination of snorers by ENT specialists is unnecessary in the absence of Hard Nasal Symptoms, hoarseness or pain. We propose that a system of triage based on patient history could help identify the minority of snorers who require specialist assessment.
确定(i)打鼾者中未被怀疑的上呼吸道和消化道疾病的患病率,(ii)常规软性内镜检查的诊断率,以及(iii)上呼吸道和消化道疾病症状与打鼾者检查结果之间的关系。
前瞻性分析队列研究。
二级护理耳鼻喉科中心的打鼾诊所。
93例因严重打鼾前来就诊的患者。
通过门诊访谈获取上呼吸道和消化道症状的结构化病史。所有患者均接受了详细的耳鼻喉科检查。对收集到的数据进行单因素分析。
该队列中口咽和喉部病变的患病率为3%。常规软性内镜检查未发现未被怀疑的上呼吸道和消化道病变。硬鼻症状史是潜在鼻病变的准确预测指标。
作者提出,在没有硬鼻症状、声音嘶哑或疼痛的情况下,耳鼻喉科专家对打鼾者进行详细检查是不必要的。我们建议基于患者病史的分诊系统有助于识别少数需要专科评估的打鼾者。