The Annals of otology, rhinology, and laryngology · 2010
Management of recurrent laryngeal sensory neuropathic symptoms.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Norris Byron K, Schweinfurth John M
Аннотация
OBJECTIVES: We identify management strategies for the treatment of upper respiratory tract symptoms stemming from dysfunction of the recurrent laryngeal nerve.
METHODS: We present a retrospective case series of patients who had symptoms of sensory neuropathy, including persistent dysphonia, laryngospasm, and chronic cough. The patients were followed for symptomatic improvement after initiation of treatment with a neuromodulator. Treatment outcome was defined by improvement or resolution of symptoms on a self-reported outcome scale.
RESULTS: Of 12 patients identified, 75% exhibited evidence of motor neuropathy on laryngoscopy and 83% had symptoms related to chronic cough treated with neuromodulator therapy over a mean follow-up of 20.4 months. The median dose of amitriptyline hydrochloride was 25 mg daily, and that of gabapentin was 300 mg 3 times daily. The mean time from the initiation of therapy to a complete response was 2 months.
CONCLUSIONS: Patients with suspected neuropathy of the recurrent laryngeal nerve frequently respond to neuromodulator therapy. The addition of reflux precautions and acid suppression therapy is helpful in cases of chronic and recurrent laryngospasm. Patients with evidence of motor neuropathy appear to have better outcomes with neuromodulator therapy.
METHODS: We present a retrospective case series of patients who had symptoms of sensory neuropathy, including persistent dysphonia, laryngospasm, and chronic cough. The patients were followed for symptomatic improvement after initiation of treatment with a neuromodulator. Treatment outcome was defined by improvement or resolution of symptoms on a self-reported outcome scale.
RESULTS: Of 12 patients identified, 75% exhibited evidence of motor neuropathy on laryngoscopy and 83% had symptoms related to chronic cough treated with neuromodulator therapy over a mean follow-up of 20.4 months. The median dose of amitriptyline hydrochloride was 25 mg daily, and that of gabapentin was 300 mg 3 times daily. The mean time from the initiation of therapy to a complete response was 2 months.
CONCLUSIONS: Patients with suspected neuropathy of the recurrent laryngeal nerve frequently respond to neuromodulator therapy. The addition of reflux precautions and acid suppression therapy is helpful in cases of chronic and recurrent laryngospasm. Patients with evidence of motor neuropathy appear to have better outcomes with neuromodulator therapy.
Предметные рубрики MeSH
Adrenergic Uptake InhibitorsAgedAminesAmitriptylineCoughCranial Nerve DiseasesCyclohexanecarboxylic AcidsDiagnosis, DifferentialDose-Response Relationship, DrugExcitatory Amino Acid AntagonistsFemaleFollow-Up StudiesGabapentinHumansLaryngoscopyMaleMiddle AgedNeurotransmitter AgentsRecurrent Laryngeal NerveRetrospective StudiesTreatment Outcomegamma-Aminobutyric Acid