Otolaryngologic presentations of amyotrophic lateral sclerosis
Otolaryngologic presentations of amyotrophic lateral sclerosis
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DOI：
10.1016/j.otohns.2004.09.092
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发表时间：
2005-03-01
影响因子：
3.4
通讯作者：
Garrett, CG
中科院分区：
文献类型：
--
作者：
Chen, A;Garrett, CG
目的/假设：确定声音障碍作为肌萎缩侧索硬化（ALS）的主要症状的发生率，并描述ALS的喉学特征。研究设计：回顾性研究。方法：回顾性分析1998年1月至2003年3月间某语音中心收治的语音障碍患者和某神经内科门诊收治的ALS患者的记录。结果：1759例声音障碍患者中有15例后来被诊断为ALS。在神经内科就诊的220例ALS患者中，44例有球部症状，19例最初就诊于耳鼻喉科。构音障碍、吞咽困难、舌束动和声带闭合不全是常见的表现。耳鼻喉科医生检查的19例ALS患者中有8例未发现神经肌肉疾病。结论：虽然耳鼻喉科医生很少遇到未确诊的ALS患者，但很大一部分球型ALS患者是由耳鼻喉科医生初步评估的。对于出现构音障碍、发音障碍或吞咽困难的患者，耳鼻喉科检查中警惕神经肌肉异常是很重要的。
OBJECTIVES/HYPOTHESIS: To determine the incidence of voice disturbance as a presenting symptom of amyotrophic lateral sclerosis (ALS) and describe laryngologic features of ALS.STUDY DESIGN: Retrospective review.METHODS: Records of patients with voice disturbance at a voice center and ALS patients at a neurology clinic were reviewed from January 1998 to March 2003.RESULTS: 15 of 1759 patients with voice disturbance were later diagnosed with ALS. Of 220 ALS patients presenting to neurology clinic, 44 had bulbar symptoms and 19 had initially presented to an otolaryngologist. Dysarthria, dysphagia, tongue fasciculation, and incomplete vocal fold closure were common findings. Neuromuscular disease was missed in 8 of 19 ALS patients seen by an otolaryngologist.CONCLUSIONS: Although otolaryngologists rarely encounter undiagnosed ALS patients, a significant portion of bulbar ALS patients are initially evaluated by otolaryngologists.SIGNIFICANCE. Vigilance for neuromuscular abnormalities on otolaryngologic exam is important in patients who present with dysarthria, dysphonia, or dysphagia.