Alanazi Alaa, Aizouki Carolin, Sloychuk Janelle, Callaghan Amy, Eksteen Eduard, Ennis Sheila, Isaac Andre
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Laryngoscope. 2025 Mar;135(3):1207-1211. doi: 10.1002/lary.31818. Epub 2024 Oct 5.
Pediatric inducible laryngeal obstruction (ILO) is difficult to diagnose and treat. Patients often undergo multiple specialist referrals, and long-term outcomes are not well reported.
To investigate the patterns of presentation, workup, and management of children who were diagnosed with ILO at the Stollery Children's Hospital.
Retrospective review with a prospective cohort of pediatric patients diagnosed with ILO from 2015 to 2023. We collected the demographic data, diagnostic tests, specialist referrals, time to diagnosis, symptom burden, associated comorbidities and aggravating factors, management, and treatment outcomes. A subset of patients was followed prospectively to determine treatment outcomes. A basic descriptive analysis was performed, and factors associated with time to resolution were studied.
Seventy-eight patients met the criteria for inclusion, with 22 completing prospective questionnaires. The average age was 14 years old, and 75% were female. The majority required multiple specialist referrals. The majority were associated with exercise. Thirty-two (41%) patients had a presumed diagnosis of asthma, despite only four pulmonary function tests being consistent with asthma. Abortive breathing exercises were the most commonly employed (95%) and most successful (61%) nonsurgical management technique. Surgery was highly successful in a small cohort of patients. Median time to symptom resolution was 12 months, with 36% reporting symptoms persistent beyond 3 years.
Pediatric ILO often goes undiagnosed for prolonged periods. Exercise-related symptoms are the most common. Management strategies have varied levels of success and a large proportion of patients have prolonged symptoms despite treatment, as supported by other recent evidence.
3 Laryngoscope, 135:1207-1211, 2025.
小儿诱发性喉梗阻（ILO）难以诊断和治疗。患者常需多次转诊至专科医生处，且长期预后报道不足。
调查在斯托利儿童医院被诊断为ILO的儿童的临床表现、检查及治疗模式。
对2015年至2023年被诊断为ILO的儿科患者进行前瞻性队列的回顾性研究。我们收集了人口统计学数据、诊断测试、专科转诊情况、诊断时间、症状负担、相关合并症和加重因素、治疗及治疗结果。对部分患者进行前瞻性随访以确定治疗结果。进行了基本的描述性分析，并研究了与症状缓解时间相关的因素。
78例患者符合纳入标准，其中22例完成了前瞻性问卷调查。平均年龄为14岁，75%为女性。大多数患者需要多次转诊至专科医生处。大多数与运动有关。32例（41%）患者被推测诊断为哮喘，尽管只有4例肺功能测试结果与哮喘相符。间歇性呼吸练习是最常用（95%）且最成功（61%）的非手术治疗技术。手术在一小部分患者中非常成功。症状缓解的中位时间为12个月，36%的患者报告症状持续超过3年。
小儿ILO常长期未被诊断。与运动相关的症状最为常见。治疗策略的成功率各不相同，且如近期其他证据所示，尽管接受了治疗，仍有很大一部分患者症状持续时间延长。
3 《喉镜》，135:1207 - 1211，2025年。
