Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
College of Medicine, The Ohio State University, Columbus, Ohio, U.S.A.
Laryngoscope. 2021 Jul;131(7):1639-1646. doi: 10.1002/lary.29283. Epub 2020 Dec 4.
OBJECTIVES/HYPOTHESES: The primary objective of this study was to determine whether the diagnosis and treatment of pediatric Paradoxical Vocal Fold Motion Disorder (PVFMD) leads to decreased asthma medication use. Our secondary objective was to determine dyspnea outcomes following diagnosis and treatment for PVFMD.
Prospective observational study.
Patients with newly diagnosed PVFMD between the ages of 11 and 17 were recruited at a single pediatric institution. A medication questionnaire and Dyspnea Index (DI) were completed at the initial visit, at the first return visit, and at greater than 6 months post-diagnosis and therapy. Laryngeal Control Therapy (LCT) consisted of teaching breathing techniques and identifying emotional, physical, and environmental contributing factors and strategies to reduce them.
Twenty-six patients were recruited to the study. There were 19/26 (73%) patients diagnosed with asthma prior to a diagnosis of PVFMD, and 26/26 (100%) patients were using an inhaler prior to the enrollment visit. Twenty-two (85%) patients completed follow-up questionnaires. Five patients participated in no therapy, seven patients in partial therapy, and 14 patients in full therapy. Significant reduction in asthma medication use was seen in the full therapy group (P < .05) and in those with exercise as their only trigger (P < .05). Furthermore, symptoms as scored by the DI decreased overall from 25.5 to 18.8 (P < .001).
Diagnosis and treatment of pediatric PVFMD leads to a decline in asthma medication use in those patients who participate in at least two LCT sessions and in those with exercise-induced PVFMD. LCT for pediatric PVFMD leads to a significant decrease in symptoms as measured by the DI.
4 Laryngoscope, 131:1639-1646, 2021.
目的/假设：本研究的主要目的是确定儿童反常声门运动障碍（PVFMD）的诊断和治疗是否会减少哮喘药物的使用。我们的次要目标是确定诊断和治疗 PVFMD 后呼吸困难的结果。
前瞻性观察性研究。
在一家儿科机构招募了年龄在 11 至 17 岁之间的新诊断为 PVFMD 的患者。在初次就诊、第一次复诊以及诊断和治疗后超过 6 个月时，完成了药物问卷和呼吸困难指数（DI）。喉控制疗法（LCT）包括教授呼吸技巧以及识别情绪、身体和环境的促成因素，并提供减少这些因素的策略。
本研究共招募了 26 名患者。在诊断为 PVFMD 之前，有 19/26（73%）名患者被诊断为哮喘，在入组前，26/26（100%）名患者使用吸入器。22（85%）名患者完成了随访问卷。5 名患者未接受任何治疗，7 名患者接受部分治疗，14 名患者接受全面治疗。在全面治疗组（P<.05）和只有运动作为触发因素的患者中（P<.05），哮喘药物的使用显著减少。此外，DI 评分的症状总体上从 25.5 下降到 18.8（P<.001）。
在至少参加两次 LCT 治疗的患者和运动诱发的 PVFMD 患者中，儿童 PVFMD 的诊断和治疗会导致哮喘药物的使用减少。LCT 治疗儿童 PVFMD 可显著降低 DI 测量的症状。
4 级喉镜，131:1639-1646，2021。
