小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 在原来的哮喘治疗中，对支气管扩张药没有响应。
- 发作性呼吸短促：迅速起病，快速消退
- 吸气困难
- 咳嗽
- 吸气性喘鸣
- 在初始暴露后，对非特异性触发源的敏感度提高
- 可触及的喉部紧张
- 意识丧失
危险因素
- 喉咽反流（LPR）
- 胃食管反流病 (GORD)
- 哮喘
- 职业/环境刺激剂暴露
- 女性
- 竞技运动
- 焦虑
- 多系统萎缩症（MSA）
- 肌肉紧张发声困难
- 内收肌喉部呼吸张力障碍
- 手术
诊断性检查
首要检查
- 挠性经鼻光纤内窥镜检查
- PFT/流量图
需考虑的检查
- 鼻窦 CT
- 喉感官辨别力测试
治疗流程
未确诊的不稳定喘鸣患者
喘鸣的稳定患者疑似继发于PVFM
没有急性喘鸣
撰稿人
作者
Sherri K. Zelazny, MA, RSLP, CCC-SLP
Senior Clinical Speech Language Pathologist
Surrey Voice Clinic
Abilities Neurological Rehabilitation
Surrey
British Columbia
Canada
利益声明
SKZ has received income from Northern Speech Services for educational webinar production on Paradoxical Vocal Fold Motion and Chronic Cough. SKZ is President of Speech and Hearing BC (2017-2019), and on the Board of Directors of Parkinson Society BC.
Susan L. Thibeault, PhD
Assistant Professor
Director of Voice and Swallowing Clinic
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
Ms Sherri K. Zelazny and Dr Susan L. Thibeault would like to gratefully acknowledge Dr Michael Johns, a previous contributor to this topic. MJ declares that he has 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.
鉴别诊断
- 哮喘
- 喉软骨软化
- 声带局部麻痹/麻痹
更多 鉴别诊断指南
- 诱发性喉阻塞：欧洲呼吸学会和欧洲喉科学会的官方联合声明
- 诱发性喉阻塞：欧洲呼吸学会和欧洲喉科学会的官方联合声明
更多 指南
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