Siewers Karina, Backer Vibeke, Walsted Emil Schwarz
Respiratory Research Unit Bispebjerg University Hospital Copenhagen Denmark.
Laryngoscope Investig Otolaryngol. 2019 Mar 6;4(2):227-233. doi: 10.1002/lio2.257. eCollection 2019 Apr.
Exercise-induced laryngeal obstruction (EILO) is a condition causing breathing difficulties and stridor during exercise. The condition has in severe cases been treated surgically with supraglottoplasty. The purpose of this systematic review is to assess the evidence and recommendations for surgical intervention in treating patients with EILO.
A systematic search was performed in PubMed and Embase to identify relevant studies describing surgical treatment of patients diagnosed with severe EILO. According to eligibility criteria, data were independently extracted by two reviewers. To assess the risk of bias of each included study, the Newcastle-Ottawa scale (NOS) was used.
The screening process identified 11 observational studies with a total of 75 patients. Findings indicated that many beneficial outcomes are to be found in surgical treatment for EILO. These indications were found both on visual verification of improvement of the laryngeal obstruction during exercise and patient self-reported symptom severity. The average NOS score (4.3) indicated low level of evidence in the included studies.
Studies reporting effects of surgical treatment of EILO have shown promising results in patients with laryngeal obstruction. However, the heterogeneity of study methodologies and the level of evidence precludes definitive recommendations for or against supraglottoplasty at this time; prospective and methodologically robust studies are now needed.
运动性喉梗阻（EILO）是一种在运动期间导致呼吸困难和喘鸣的病症。在严重情况下，该病症已通过声门上成形术进行手术治疗。本系统评价的目的是评估手术干预治疗EILO患者的证据和建议。
在PubMed和Embase中进行系统检索，以识别描述诊断为重度EILO患者手术治疗的相关研究。根据纳入标准，由两名评价者独立提取数据。为评估每项纳入研究的偏倚风险，使用了纽卡斯尔-渥太华量表（NOS）。
筛选过程确定了11项观察性研究，共75例患者。结果表明，EILO手术治疗有许多有益结果。这些结果在运动期间喉镜检查证实喉梗阻改善以及患者自我报告的症状严重程度方面均有发现。平均NOS评分（4.3）表明纳入研究中的证据水平较低。
报告EILO手术治疗效果的研究在喉梗阻患者中显示出有前景的结果。然而，研究方法的异质性和证据水平使得目前无法对声门上成形术给出明确的支持或反对建议；现在需要进行前瞻性且方法严谨的研究。
4级
