Paradoxical vocal cord dysfunction in juveniles
Paradoxical vocal cord dysfunction in juveniles
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DOI：
10.1001/archotol.126.1.29
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发表时间：
2000-01-01
影响因子：
--
通讯作者：
Forrest, LA
中科院分区：
文献类型：
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作者：
Powell, DM;Karanfilov, BI;Forrest, LA
目的：评价一大批患有反常声带功能障碍(PVCD)的青少年患者的人口学和电视喉镜特征。设计：以蒙面、对照的方式对电视喉镜录像带的病例系列数据进行回顾性评估，并通过回顾病历收集人口学数据。地点：三级护理耳鼻喉科和言语病理转诊中心。患者：22名18岁及以下的PVCD患者，在哥伦布市俄亥俄州立大学声音研究所被诊断为PVCD。主要观察指标：年龄、性别、社会史和医学史(人口统计学)；结果：22例患者中，18例为女孩，12例有明显的社会应激源，尤其是有组织的运动。19例患者有常见于胃食道反流病的喉后改变。12例患者静息时真声带内收异常。7例患者发声时表现为声门上前后部收缩和假性声带逼近。结论：青少年PVCD在女孩中更为常见，并与社会压力有关。典型的与胃食道反流病相关的喉部解剖改变在这些患者中非常常见。患有PVCD的青少年在安静呼吸时经常表现出异常的真声带内收。我们建议在青少年患者没有症状时，通过鼻腔纤维喉镜对可能的PVCD进行初步评估，并强烈考虑对诊断为PVCD的青少年胃食道反流病进行经验性药物治疗。
Objective: To evaluate demographic and videolaryngoscopic features in a large series of juveniles with paradoxical vocal cord dysfunction (PVCD).Design: Case series data from videolaryngoscopic tapes retrospectively evaluated in a masked, controlled fashion, and demographic data collected via retrospective medical chart review.Setting: A tertiary care otolaryngology and speech pathology referral center.Patients: Twenty-two patients with PVCD aged 18 years and younger diagnosed as having PVCD at The Ohio State University Voice Institute, Columbus.Main Outcome Measures: Age, sex, social history, and medical history (demographic); epiglottic position, arytenoid and interarytenoid appearance, phase 0 stability, true vocal cord respiratory motion, degree of anteroposterior (AP) constriction, and false vocal cord adduction (videolaryngoscopic)Results: Of 22 patients, 18 were girls, and 12 had significant social stressors, particularly organized sports. Nineteen patients had posterior laryngeal changes commonly found in gastroesophageal reflux disease. Twelve patients demonstrated abnormal true vocal cord adduction during quiet respiration. Seven patients demonstrated supraglottic anteroposterior constriction and false vocal cord approximation during phonation.Conclusions: Juvenile PVCD is more common in girls and is associated with social stresses. Anatomic laryngeal changes typically associated with gastroesophageal reflux disease are extremely common in these patients. Juveniles with PVCD frequently demonstrate abnormal true vocal cord adduction during-quiet respiration. We recommend that initial evaluation of juvenile patients for possible PVCD be conducted via transnasal fiberoptic laryngoscopy while the patient is asymptomatic, and that strong consideration be given to empiric pharmacological treatment of gastroesophageal reflux disease in juveniles diagnosed as having PVCD.