Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Clin Exp Allergy. 2020 Dec;50(12):1287-1293. doi: 10.1111/cea.13745. Epub 2020 Oct 8.
Prior to the COVID-19 pandemic, laryngoscopy was the mandatory gold standard for the accurate assessment and diagnosis of inducible laryngeal obstruction. However, upper airway endoscopy is considered an aerosol-generating procedure in professional guidelines, meaning routine procedures are highly challenging and the availability of laryngoscopy is reduced. In response, we have convened a multidisciplinary panel with broad experience in managing this disease and agreed a recommended strategy for presumptive diagnosis in patients who cannot have laryngoscopy performed due to pandemic restrictions. To maintain clinical standards whilst ensuring patient safety, we discuss the importance of triage, information gathering, symptom assessment and early review of response to treatment. The consensus recommendations will also be potentially relevant to other future situations where access to laryngoscopy is restricted, although we emphasize that this investigation remains the gold standard.
在 COVID-19 大流行之前,喉镜检查是准确评估和诊断可诱导性喉阻塞的强制性金标准。然而,根据专业指南,上气道内镜检查被认为是一种产生气溶胶的程序,这意味着常规程序极具挑战性,喉镜检查的可及性降低。有鉴于此,我们召集了一个具有广泛管理这种疾病经验的多学科小组,并就无法进行喉镜检查的患者的疑似诊断达成了推荐策略。为了在确保患者安全的同时保持临床标准,我们讨论了分诊、信息收集、症状评估以及对治疗反应的早期复查的重要性。这些共识建议也可能与未来其他限制喉镜检查的情况下相关,尽管我们强调该检查仍然是金标准。