Stachler Robert J, Dworkin-Valenti James P
aDownriver ENT PC bDepartment of Otolaryngology, Wayne State University, Detroit Medical Center, Detroit, MI.
Curr Opin Otolaryngol Head Neck Surg. 2017 Jun;25(3):242-246. doi: 10.1097/MOO.0000000000000354.
This article provides a thorough review of the literature highlighting the articles that have advanced our knowledge about the sensitivity of the larynx to allergens in the air or ones consumed. This area of inquiry requires continued interest and investigation. As the field of clinical laryngology changes, and more information is discovered about the possible causal association between allergy and vocal pathologies, practicing otolaryngologists, allergists, and other medical professionals may discover more comprehensive methods to evaluate and treat their allergic patients, particularly those who present with complaints of dysphonia, dysphagia, laryngopharyngeal reflux (LPR), and/or dyspnea.
There continues to be epidemiological studies designed to describe the relationship of allergy to vocal symptoms and signs. Both population and smaller studies have recently attempted to link these two conditions. Unfortunately, the patient with chronic laryngeal complaints is often tagged by default with the diagnosis of LPR and treated with proton pump inhibitors, which are not always beneficial. The endoscopic assessment may not be as reliable to make the diagnosis of LPR as the examination is subjective and the inter-rater reliability is low. It has been demonstrated by direct laryngeal provocation studies that sticky-viscous endo-laryngeal mucous is the only reliable finding consistently associated with allergy potential allergic tissue reactivity.
The interrelationship of allergic sensitivity and chronic laryngitis in certain individuals is becoming clearer because our knowledge of inquiry has increased and the available routine technology to diagnose these conditions has remarkably improved. Notwithstanding these advancements, much more research is needed on this subject to reduce the frequency of mis-diagnoses and mis-management of allergic patients.
本文全面回顾了相关文献，重点介绍了那些增进我们对喉部对空气中或摄入的过敏原敏感性认识的文章。这一研究领域需要持续关注和调查。随着临床喉科学领域的变化，以及关于过敏与嗓音疾病之间可能的因果关系发现了更多信息，执业耳鼻喉科医生、过敏症专科医生和其他医学专业人员可能会找到更全面的方法来评估和治疗他们的过敏患者，尤其是那些有声音嘶哑、吞咽困难、喉咽反流（LPR）和/或呼吸困难症状的患者。
仍有旨在描述过敏与嗓音症状和体征关系的流行病学研究。近期，大规模人群研究和小规模研究都试图将这两种情况联系起来。不幸的是，慢性喉部不适的患者常常默认被诊断为LPR，并接受质子泵抑制剂治疗，但这种治疗并不总是有益的。内镜评估在诊断LPR方面可能并不那么可靠，因为检查具有主观性且评估者间的可靠性较低。直接喉部激发试验表明，粘性的喉内黏液是唯一与潜在过敏组织反应性持续相关的可靠发现。
由于我们的研究知识有所增加，且诊断这些疾病的现有常规技术有了显著改进，某些个体中过敏敏感性与慢性喉炎之间的相互关系正变得更加清晰。尽管有这些进展，但在这个问题上仍需要更多研究，以减少过敏患者误诊和管理不当的发生率。
