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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Laryngeal sensory deficits in patients with chronic cough and paradoxical vocal fold movement disorder.
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Laryngeal sensory deficits in patients with chronic cough and paradoxical vocal fold movement disorder.

机译：慢性咳嗽和矛盾的声带运动障碍患者的喉部感觉缺陷。

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OBJECTIVES/HYPOTHESIS: Although the diagnostic accuracy of paradoxical vocal fold movement disorder and chronic cough has improved, the underlying pathophysiology remains relatively unknown. We hypothesize that one potential etiological factor in these patients is an aberrant laryngeal sensory response and sought to determine if respiratory retraining in addition to antireflux therapy alters this aberrant response. STUDY DESIGN: Retrospective, outcomes. METHODS: Sixteen patients who had been on at least 3 months of twice-daily proton pump inhibitors with no subjective improvement in their primary complaint of cough, self-reported symptoms of gastroesophageal and laryngopharyngeal reflux, and concurrent paradoxical vocal fold movement (PVFM) were included in the current study. In addition to continuing twice daily pharmacological therapy, subjects underwent a course of respiratory retraining. Outcome measures including the Reflux Symptom Index (RSI), transnasal flexible laryngoscopy, and laryngopharyngeal sensory discrimination thresholds were obtained prior to and following a course of respiratory retraining. RESULTS: Mean bilateral laryngeal sensory response improved significantly after combined respiratory retraining and aggressive proton pump inhibitor therapy (P = .01). In addition, mean RSI score decreased significantly following treatment (P = .02). Specifically, 13 of 16 patients experienced improved sensory response, corresponding with patient reports of improved PVFM symptoms following treatment. CONCLUSIONS: Aberrant laryngeal sensation was identified in patients with PVFM and chronic cough. This response, however, normalized following a limited course of respiratory retraining, corresponding with improved patient symptoms.
机译：目的/假设：尽管自相矛盾的声带运动障碍和慢性咳嗽的诊断准确性有所提高，但其潜在的病理生理学仍然相对未知。我们假设这些患者的一种潜在病因是喉部感觉异常反应，并试图确定除抗返流疗法外的呼吸再训练是否会改变这种异常反应。研究设计：回顾性，结果。方法：16例患者接受了至少3个月的每日两次质子泵抑制剂治疗，其主诉咳嗽，自我报告的胃食管和喉咽反流症状以及并发的自相矛盾的声带折叠运动（PVFM）均无主观改善。包括在当前研究中。除了每天持续进行两次药理治疗外，受试者还接受了呼吸再训练。在进行呼吸再训练之前和之后，获得了包括反流症状指数（RSI），经鼻柔性喉镜检查和喉咽感觉辨别阈值在内的结果指标。结果：联合呼吸再训练和积极的质子泵抑制剂治疗后，平均双侧喉部感觉反应明显改善（P = .01）。此外，治疗后平均RSI得分显着降低（P = .02）。具体而言，在16位患者中，有13位患者的感觉反应得到改善，与患者治疗后PVFM症状得到改善的报道相对应。结论：在患有PVFM和慢性咳嗽的患者中发现了喉部异常感觉。但是，这种反应在呼吸再训练的有限过程后恢复了正常，与患者症状的改善相对应。

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