Dept of Pediatrics, Haukeland University Hospital and Department of Clinical Science, University of Bergen, Bergen, Norway
Dept of Respiratory Medicine, Royal Brompton Hospital, London, UK.
Eur Respir J. 2017 Sep 9;50(3). doi: 10.1183/13993003.02221-2016. Print 2017 Sep.
Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenclature and variable approaches to assessment and management. A task force of the European Respiratory Society (ERS) and European Laryngological Society (ELS) was thus set up to address this, and to identify research priorities.A literature search identified relevant articles published until June 2016, using all identifiable terms for ILO, although including only articles using laryngoscopy. In total, 172 out of 252 articles met the inclusion criteria, summarised in sections on diagnostic approach, aetiology, comorbidities, epidemiology and treatment. The consensus taxonomy published by ERS, ELS and the American College of Chest Physicians (ACCP) in 2015 is used throughout this statement.We highlight the high prevalence of ILO and the clinical impact for those affected. Despite recent advances, most aspects of this condition unfortunately remain incompletely understood, precluding firm guidance. Specifically, validated diagnostic and treatment algorithms are yet to be established, and no randomised control studies were identified in this search; hence we also make recommendations for future research.
诱导性喉阻塞 (ILO) 是指由于外部刺激而导致的喉不适当、短暂、可逆性狭窄。ILO 是多种呼吸症状的重要原因,并可模仿哮喘。目前对 ILO 的认识受到不精确的命名和评估及管理方法多变的阻碍。因此,欧洲呼吸学会 (ERS) 和欧洲喉科学会 (ELS) 成立了一个工作组来解决这个问题,并确定研究重点。使用所有可识别的 ILO 术语进行了文献检索,尽管仅包括使用喉镜的文章,但直到 2016 年 6 月,共检索到 252 篇文章中的 172 篇符合纳入标准,总结在诊断方法、病因、合并症、流行病学和治疗方面的部分。ERS、ELS 和美国胸科医师学会 (ACCP) 于 2015 年发布的共识分类法在本声明中被通篇使用。我们强调了 ILO 的高患病率以及对受影响者的临床影响。尽管最近取得了进展,但不幸的是,该病症的大多数方面仍未被完全理解,从而无法提供明确的指导。具体而言,尚未建立经过验证的诊断和治疗算法,并且在本次搜索中没有发现随机对照研究;因此,我们还为未来的研究提出了建议。