Speech Pathology Department, John Hunter Hospital, Newcastle, NSW, Australia; Priority Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
Speech Pathology Department, John Hunter Hospital, Newcastle, NSW, Australia.
J Allergy Clin Immunol Pract. 2022 Feb;10(2):597-601.e1. doi: 10.1016/j.jaip.2021.10.017. Epub 2021 Oct 16.
Chronic cough and vocal cord dysfunction are manifestations of laryngeal hypersensitivity syndrome.
The aim of the study was to determine the clinical utility of functional transnasal laryngoscopy in patients with laryngeal hypersensitivity syndromes.
This study was a prospective observational cross-sectional study design of 71 participants with laryngeal hypersensitivity syndrome referred for functional transnasal laryngoscopy. Participants had a clinical assessment with a speech pathologist after which a provisional diagnosis of chronic cough, suspected vocal cord dysfunction, suspected muscle tension dysphonia, or a combination was made. A laryngoscopy with provocation was performed and the diagnosis revised after which the provisional and revised diagnoses were compared.
The diagnosis changed in 67% of participants after laryngoscopy. Vocal cord dysfunction was diagnosed in an additional 17 cases when not expected clinically but discounted when suspected clinically in 12 participants. Muscle tension dysphonia was diagnosed in an additional 31 cases when not suspected clinically and not confirmed when suspected in 2.
This study demonstrated that conditions such as muscle tension dysphonia and vocal cord dysfunction cannot be diagnosed based on symptoms alone. In addition to diagnostic accuracy, functional laryngoscopy enhances treatment planning and provides immediate feedback regarding laryngeal movement during respiration and phonation.
慢性咳嗽和声带功能障碍是喉高敏综合征的表现。
本研究旨在确定功能性经鼻喉镜检查在喉高敏综合征患者中的临床应用价值。
这是一项对 71 例喉高敏综合征患者进行功能性经鼻喉镜检查的前瞻性观察性横断面研究。患者在接受言语病理学家的临床评估后，做出慢性咳嗽、疑似声带功能障碍、疑似肌肉紧张性发音障碍或上述情况综合的初步诊断。进行喉镜激发检查，并在检查后对诊断进行修订，然后比较初步诊断和修订诊断。
喉镜检查后，67%的患者的诊断发生了变化。在 17 例临床预期外的病例中诊断为声带功能障碍，而在 12 例临床可疑病例中排除了声带功能障碍的诊断。在 31 例临床未怀疑但在怀疑时未确诊的病例中诊断为肌肉紧张性发音障碍。
本研究表明，肌肉紧张性发音障碍和声带功能障碍等疾病不能仅根据症状进行诊断。除了诊断准确性之外，功能喉镜还可增强治疗计划，并提供呼吸和发声时声带运动的即时反馈。
