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Movimento paradoxal das pregas vocais (obstrução intermitente da laringe)

最后审阅: 17 Aug 2025
最后更新: 08 Apr 2025

小结

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • tratamento prévio para asma sem resposta a broncodilatadores
  • dispneia episódica: início e resolução rápidos
  • dificuldade para inalar
  • tosse
  • estridor inspiratório
  • aumento da sensibilidade a fatores desencadeantes inespecíficos após exposição inicial
  • tensão laríngea palpável
  • perda de consciência
完整详情

危险因素

  • refluxo laringofaríngeo (RLF)
  • Doença do refluxo gastroesofágico (DRGE)
  • asma
  • exposição ocupacional/ambiental a irritantes
  • sexo feminino
  • atividades atléticas competitivas
  • ansiedade
  • disfonia de tensão muscular
  • distonia laríngea respiratória adutora
  • cirurgia
完整详情

诊断性检查

首要检查

  • nasofibrolaringoscopia
  • teste de função pulmonar (TFP)/traçado de fluxo-volume
完整详情

需考虑的检查

  • tomografia computadorizada (TC) dos seios da face
  • teste de discriminação sensorial da laringe
完整详情

治疗流程

急症处理

paciente instável, não diagnosticado com estridor

paciente estável com estridor suspeito de ser decorrente do MPPV/OIL

持续性治疗

sem estridor agudo

撰稿人

作者

Rita Patel, PhD, CCC-SLP

Associate Professor

Department of Speech, Language and Hearing Sciences

Indiana University Bloomington

Bloomington

IN

利益声明

RP is on the Board of Trustees for the American Speech-Language-Hearing Foundation, Editor-In-Chief for the American Journal of Speech-Language Pathology, an educational course content developer for Northern Speech Services, and has received grants or pending grants from the National Institutes of Health, and employment at Indiana University.

Susan L. Thibeault, PhD
Susan L. Thibeault

Professor

UWHealth Medical Director of Speech and Hearing Services

Division of Otolaryngology - Head and Neck Surgery

University of Wisconsin School of Medicine and Public Health

Health Sciences Learning Center

Madison

WI

利益声明

SLT declares that she has no competing interests.

鸣谢

Dr Rita Patel and Dr Susan L. Thibeault would like to gratefully acknowledge Dr Michael Johns and Ms Sheeri K. Zelazny, previous contributors to this topic. MJ and SZ declare that they have no competing interests.

同行评议者

Julina Ongkasuwan, MD

Associate Professor

Otolaryngology - Head and Neck Surgery

Baylor College of Medicine

Texas Children’s Hospital

Houston

TX

利益声明

JO receives book royalties from Springer and Elsevier.

Janet Wilson, BSc, MD, FRCSEd, FRCSEng

Professor of Otolaryngology - Head and Neck Surgery

Newcastle University

Honorary Consultant Otolaryngologist

Freeman Hospital

Newcastle-Upon-Tyne

UK

利益声明

JW declares that she has no competing interests.

Ryner Jose Dela Cruz Carrillo, MD, MSc, FPSOHNS, FPAHNS

Associate Professor

Department of Otorhinolaryngology

Department of Anatomy

University of the Philippines

College of Medicine

Manila

Philippines

利益声明

RJDCC declares that he has no competing interests.

Tom Murry, PhD

Professor of Speech Pathology

Department of Otolaryngology - Head and Neck Surgery

Clinical Director of the Voice and Swallowing Center

College of Physicians and Surgeons

Columbia University at New York Presbyterian Hospital

New York

NY

利益声明

TM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Morris MJ, Allan PF, Perkins PJ. Vocal cord dysfunction: etiologies and treatment. Clin Pulm Med. 2006;13:73-86.

Clemm HH, Olin JT, McIntosh C, et al. Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC Consensus on 'acute respiratory illness in the athlete'. Br J Sports Med. 2022 Jun;56(11):622-9.全文  摘要

Leong P, Vertigan AE, Hew M, et al. Diagnosis of vocal cord dysfunction/inducible laryngeal obstruction: an international delphi consensus study. J Allergy Clin Immunol. 2023 Oct;152(4):899-906.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Movimento paradoxal das pregas vocais (obstrução intermitente da laringe) images
  • 鉴别诊断

    • Asma
    • Laringomalácia
    • Paralisia/paresia das pregas vocais
    更多 鉴别诊断
  • 指南

    • Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement
    • Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement
    更多 指南
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