Olin J Tod, Deardorff Emily H, Fan Elizabeth M, Johnston Kristina L, Keever Valerie L, Moore Camille M, Bender Bruce G
Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, Colorado.
Department of Rehabilitation Medicine, National Jewish Health, Denver, Colorado.
Pediatr Pulmonol. 2017 Jun;52(6):813-819. doi: 10.1002/ppul.23634. Epub 2016 Oct 31.
Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions.
This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness.
Clinical EILO patients with symptoms refractory to conventional respiratory retraining and other therapies were referred for the procedure which features laryngoscopy video as biofeedback during serial physician-guided 1-min exercise sprints. We quantify perceptions of procedure safety, tolerability, learning value, and effectiveness through questionnaires offered to all patients as well as observers of the procedure.
Forty-one patients and 37 parent observers were approached for feedback; 88% of patients and 95% of observers consented to participation. Patients and observers reported perceptions of safety and tolerability (81% and 86%, respectively), learning value (78% and 91%, respectively), and effectiveness (58% and 80%, respectively) with patient age predicting some responses. Seventy-five percent of patients noted that "Since the procedure, my breathing during exercise has improved," and 85% of this group noted that therapeutic laryngoscopy during exercise was "the most important therapy leading to my breathing improvement." The procedure also provided insight into the psychological experience of patients, a domain not clinically apparent prior to the procedure.
Our data support further study of therapeutic laryngoscopy during exercise as a possible intervention for patients with refractory EILO. Pediatr Pulmonol. 2017;52:813-819. © 2016 Wiley Periodicals, Inc.
运动性喉梗阻（EILO）可能影响多达6%的青少年人群，一些患者的症状对保守干预措施无效。
本报告描述了运动期间的治疗性喉镜检查，这是一种新型非手术干预措施，利用实时喉镜视频作为生物反馈，在高强度运动期间控制喉口。此外，我们对患者报告的手术安全性、耐受性、学习价值和有效性的认知进行了量化。
对常规呼吸再训练和其他治疗方法无效的临床EILO患者转诊接受该手术，该手术的特点是在医生指导的连续1分钟运动冲刺过程中，将喉镜视频作为生物反馈。我们通过向所有患者以及手术观察者提供的问卷，对手术安全性、耐受性、学习价值和有效性的认知进行量化。
我们向41名患者和37名家长观察者征求反馈意见；88%的患者和95%的观察者同意参与。患者和观察者报告了对安全性和耐受性（分别为81%和86%）、学习价值（分别为78%和91%）以及有效性（分别为58%和80%）的认知，患者年龄对一些回答有预测作用。75%的患者指出“自手术以来，我运动时的呼吸有了改善”，该组中85%的患者指出运动期间的治疗性喉镜检查是“导致我呼吸改善的最重要治疗方法”。该手术还深入了解了患者的心理体验，这是手术前临床上不明显的一个领域。
我们的数据支持进一步研究运动期间的治疗性喉镜检查，作为难治性EILO患者的一种可能干预措施。《儿科肺病学》。2017年；52:813 - 819。©2016威利期刊公司。
