Hočevar-Boltežar Irena, Krivec Uroš, Šereg-Bahar Maja
aDepartment for Otorhinolaryngology and Cervicofacial Surgery bUnit for Pulmonary Diseases, University Medical Centre of Ljubljana, University Children's Hospital cFaculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Int J Rehabil Res. 2017 Jun;40(2):146-151. doi: 10.1097/MRR.0000000000000222.
Exercise-inducible laryngeal obstruction (EILO) has been recognized as a not rare respiratory problem in youth practicing sports. The aim of the study was to test the mechanosensitivity of the larynx, and to identify the factors affecting it in a group of youth with proven EILO. Laryngeal sensory testing was performed in 54 adolescents and young adults with EILO. Laryngeal mucosal alterations were assessed according to the Reflux Finding Score (RFS). The data concerning diseases possibly affecting the upper airway, findings of previously performed flexible videolaryngoscopy during exercise, and RFS score were compared between the participants with laryngeal hyposensitivity and those with normal sensitivity. The participants with isolated vocal folds' adduction during an EILO attack were compared with those who demonstrated supraglottis collapse. Testing revealed an increased threshold for mechanical stimuli in 81.5% of participants. Among participants with hyposensitivity, there were significantly more participants with dysphagia during EILO attacks than among the participants with normal laryngeal sensitivity. The hyposensitivity group had a significantly higher RFS score compared with the other group. Isolated vocal folds' approximation was only observed in 11.9% of participants. These participants were younger and had asthma more frequently compared with the others. Only 16.9% of participants with EILO did not state symptoms related to gastroesophageal reflux. The decreased mechanosensitivity was detected in the majority of participants, suggesting that laryngopharyngeal reflux can be an important etiological factor. The problem of breathing difficulties during sport activities in youth can also be associated with the disproportionate growth of the respiratory tract.
运动诱发性喉梗阻（EILO）已被认为是从事体育运动的青少年中并不罕见的呼吸问题。本研究的目的是测试喉部的机械敏感性，并在一组确诊为EILO的青少年中确定影响其的因素。对54名患有EILO的青少年和青年成人进行了喉部感觉测试。根据反流发现评分（RFS）评估喉部黏膜改变。比较了喉部感觉减退者和感觉正常者之间可能影响上呼吸道的疾病数据、先前运动期间进行的软性视频喉镜检查结果以及RFS评分。将EILO发作期间出现孤立性声带内收的参与者与出现声门上塌陷的参与者进行了比较。测试显示81.5%的参与者对机械刺激的阈值增加。在感觉减退的参与者中，EILO发作期间吞咽困难的参与者明显多于喉部感觉正常的参与者。感觉减退组的RFS评分明显高于另一组。仅11.9%的参与者出现孤立性声带接近。与其他参与者相比，这些参与者更年轻且更频繁地患有哮喘。仅有16.9%的EILO参与者未陈述与胃食管反流相关的症状。大多数参与者检测到机械敏感性降低，这表明喉咽反流可能是一个重要的病因因素。青少年体育活动期间的呼吸困难问题也可能与呼吸道的不成比例生长有关。
