Respsono Clinic, São Bernardo do Campo, Brazil.
ABC Foundation School of Medicine, Santo André, Brazil.
Laryngoscope. 2020 May;130(5):E349-E356. doi: 10.1002/lary.28213. Epub 2019 Jul 30.
Using a method developed for this study, the objective was to perform a quantitative analysis of glottic aperture during the respiratory cycle in subjects suspected of having inducible laryngeal obstruction (ILO) and to compare results to healthy individuals. Correlations between glottic aperture and spirometric parameters were assessed.
Subjects with high clinical suspicion of ILO and atypical inspiratory findings in spirometry had the images of their laryngoscopy displayed alongside a respiratory flow chart and both were recorded simultaneously. This method allowed detailed analysis of the glottic aperture by measuring the angle of the anterior commissure during inspiration and expiration. Healthy volunteers who performed the same tests and agreed to provide data to this study were used as a control group.
All 15 subjects with ILO and 16 healthy participants were evaluated successfully using the proposed method. Measures of the anterior commissure angle in the ILO versus control group were significantly different in all observed parameters and just three ILO subjects had an anterior commissure closure greater than 50% during the respiratory cycle. Inspired volume (FIF ) and mid-vital capacity ratio (FEF /FIF ) had a significant correlation with glottic aperture parameters when considering the evaluation of the subjects all together.
The proposed method provided precise and quantitative analysis of glottic aperture during the respiratory cycle thus indicating that the usage of equipment that allows for such assessment should be encouraged. Also, the threshold of vocal cords closure accepted as indicative of ILO should be reconsidered, especially during the intercritical period of the disease.
4 Laryngoscope, 130:E349-E356, 2020.
使用为本研究开发的方法，定量分析怀疑患有可诱导性喉阻塞（ILO）的患者在呼吸周期中的声门孔径，并将结果与健康个体进行比较。评估了声门孔径与肺功能参数之间的相关性。
具有 ILO 高度临床怀疑和肺功能检查中吸气异常表现的受试者，其喉镜图像与呼吸流量图表并列显示，同时进行记录。这种方法允许通过测量前连合在吸气和呼气期间的角度来对声门孔径进行详细分析。进行了相同测试并同意向本研究提供数据的健康志愿者被用作对照组。
使用提出的方法成功评估了所有 15 例 ILO 患者和 16 例健康参与者。在所有观察到的参数中，ILO 组与对照组的前连合角度测量值均有显著差异，在整个呼吸周期中仅有 3 例 ILO 患者的前连合闭合度大于 50%。吸气量（FIF）和中肺活量比（FEF/FIF）与声门孔径参数具有显著相关性，当考虑所有受试者的评估时。
提出的方法提供了呼吸周期中声门孔径的精确和定量分析，这表明应该鼓励使用允许进行此类评估的设备。此外，应重新考虑作为 ILO 指示性的声带闭合阈值，尤其是在疾病的间歇期。
4 Laryngoscope，130：E349-E356，2020 年。
