Schonman Ian, Mudd Pamela A, Ivancic Ryan, Ryan Marisa A, Ongkasuwan Julina, Prager Jeremy, Smith Marshall E, Goudy Steven L, Rana Md Sohel, Wiet Gregory J, Bauman Nancy M
GW School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Department of Otolaryngology, Children's National Health System, Washington, District of Columbia, USA.
Laryngoscope. 2023 Apr;133(4):970-976. doi: 10.1002/lary.30256. Epub 2022 Jun 22.
To explore patient-reported outcome measures of pediatric paradoxical vocal fold motion through a multi-institutional study of geographically diverse United States medical facilities to assess long-term management and outcomes.
Eligible participants >8 years of age diagnosed with PVFM over a 10-year period from 7 tertiary pediatric hospitals were invited to complete a survey addressing study objectives.
65 participants completed the survey, of whom 80% were female, 75% reported a 3.5 grade point average or better, and 75% identified as competitive athletes or extremely athletic individuals. Participants rated their perceived efficacy of 13 specific treatments. Only five treatments were considered effective by a majority of the participants who tried them. The treatments that participants tried most often were breathing exercises (89.2%), bronchodilator treatments (45%), and allergy medications (35.4%). 78.8% of participants reported receiving more than one treatment and 25% reported receiving a combination of bronchodilators, anticholinergics, and steroids. At the time of PVFM diagnosis, 38% of participants had no idea when their symptoms would completely resolve. 23.3% of participants did not experience symptom resolution until greater than 1 year after diagnosis.
Traditional management tools such as breathing exercises and biofeedback treatments may not provide the long-term benefit that providers anticipate. In addition to these commonly used management strategies, highly efficacious techniques such as counseling and lifestyle management should be incorporated into the long-term management of patients whose symptoms are refractory to traditional care.
4 Laryngoscope, 133:970-976, 2023.
通过对美国不同地理位置的多家医疗机构进行多机构研究，探讨儿科反常性声带运动的患者报告结局指标，以评估长期管理及结果。
邀请来自7家三级儿科医院、在10年期间被诊断为反常性声带运动功能障碍（PVFM）且年龄大于8岁的符合条件的参与者完成一项针对研究目标的调查。
65名参与者完成了调查，其中80%为女性，75%报告平均绩点为3.5或更高，75%将自己认定为竞技运动员或运动能力极强的个体。参与者对13种特定治疗方法的感知疗效进行了评分。尝试过这些治疗方法的参与者中，只有五种被大多数人认为有效。参与者最常尝试的治疗方法是呼吸练习（89.2%）、支气管扩张剂治疗（45%）和抗过敏药物（35.4%）。78.8%的参与者报告接受了不止一种治疗，25%的参与者报告接受了支气管扩张剂、抗胆碱能药物和类固醇的联合治疗。在PVFM诊断时，38%的参与者不知道症状何时会完全缓解。23.3%的参与者直到诊断后1年多才症状缓解。
呼吸练习和生物反馈治疗等传统管理工具可能无法提供医生预期的长期益处。除了这些常用的管理策略外，对于症状对传统治疗无效的患者，应将咨询和生活方式管理等高效技术纳入长期管理中。
4《喉镜》，133:970 - 976，2023年。
