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irritable larynx syndrome

Jeremy Berger, Michael P Carroll, Edward Champoux, Christopher A Coop
We present a case with extremely late diagnosis of type II hereditary angioedema (HAE). Given recent advances in HAE treatment, we want to bring physician awareness to this condition and aid in earlier detection. HAE is a disorder associated with episodes of angioedema of the face, larynx, lips, abdomen, or extremities. Late diagnosis of HAE can lead to significant morbidity and is severely impairing due to recurring attacks. The diagnosis of HAE is ordinarily made during childhood and adolescence. Delayed diagnoses in early and middle adulthood have been documented in the literature...
March 26, 2018: Military Medicine
Luis F Giraldo-Cadavid, Luis Mauricio Agudelo-Otalora, Javier Burguete, Mario Arbulu, William Daniel Moscoso, Fabio Martínez, Andrés Felipe Ortiz, Juan Diaz, Jaime A Pantoja, Andrés Felipe Rueda-Arango, Secundino Fernández
BACKGROUND: Laryngo-pharyngeal mechano-sensitivity (LPMS) is involved in dysphagia, sleep apnea, stroke, irritable larynx syndrome and cough hypersensitivity syndrome among other disorders. These conditions are associated with a wide range of airway reflex abnormalities. However, the current device for exploring LPMS is limited because it assesses only the laryngeal adductor reflex during fiber-optic endoscopic evaluations of swallowing and requires a high degree of expertise to obtain reliable results, introducing intrinsic expert variability and subjectivity...
May 10, 2016: Biomedical Engineering Online
S N Tan, H S Gendeh, A Sani, M Mat-Baki
INTRODUCTION: Myeloid Sarcoma (MS) or Granulocytic Sarcoma is an uncommon laryngeal malignancy. It may arise from myelodysplastic syndromes, malignancy or de novo. Presentation in the larynx is rare and some may present with Acute Myeloid Leukaemia (AML) whereby the later may be asymptomatic. CASE PRESENTATION: A 44-year-old South East Asian lady presented with a six months history of hoarseness, shortness of breath, reduced exercise tolerance, weight loss and laryngeal irritation...
2016: International Journal of Surgery Case Reports
Adrianna C Shembel, Mary J Sandage, Katherine Verdolini Abbott
OBJECTIVE: The purposes of this literature review were (1) to identify and assess frameworks for clinical characterization of episodic laryngeal breathing disorders (ELBD) and their subtypes, (2) to integrate concepts from these frameworks into a novel theoretical paradigm, and (3) to provide a preliminary algorithm to classify clinical features of ELBD for future study of its clinical manifestations and underlying pathophysiological mechanisms. STUDY DESIGN: This is a literature review...
January 2017: Journal of Voice: Official Journal of the Voice Foundation
Jennifer A Anderson
PURPOSE OF REVIEW: The purpose of this study is to review the relevant literature concerning work-associated irritable larynx syndrome (WILS), a hyperkinetic laryngeal disorder associated with occupational irritant exposure. Clinical symptoms are variable and include dysphonia, cough, dyspnoea and globus pharyngeus. WILS is a clinical diagnosis and can be difficult to differentiate from asthma. Treatment options for WILS include medical and behavioural therapy. RECENT FINDINGS: Laryngeal-centred upper airway symptoms secondary to airborne irritants have been documented in the literature under a variety of diagnostic labels, including WILS, vocal cord dysfunction (VCD), laryngeal hypersensitivity and laryngeal neuropathy and many others...
April 2015: Current Opinion in Allergy and Clinical Immunology
Anne E Vertigan, Sarah L Bone, Peter G Gibson
BACKGROUND: Laryngeal hypersensitivity may be an important component of the common disorders of laryngeal motor dysfunction including chronic refractory cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. Patients with these conditions frequently report sensory disturbances, and an emerging concept of the 'irritable larynx' suggests common features of a sensory neuropathic dysfunction as a part of these disorders. The aim of this study was to develop a Laryngeal Hypersensitivity Questionnaire for patients with laryngeal dysfunction syndromes in order to measure the laryngeal sensory disturbance occurring in these conditions...
2014: Cough
M Jungheim, S Miller, M Ptok
BACKGROUND: A clicking noise in the larynx can probably be provoked in many adults. However, these clicks are not usually associated with pain and physicians are not consulted. The combination of a clicking larynx and pain may severely reduce an individual's quality of life. Up until now, the so-called clicking larynx syndrome (CLS) has not been defined in German teaching literature. Therefore, this article reviews the international literature on CLS and also presents three case reports...
November 2013: HNO
S Meyer, M Ptok
The term 'laryngeal neuropathy' (LN) has first been used in veterinary medicine to describe an idiopathic and typically exercise induced inspiratory noise in horses.Nowadays, the term is often used in relation with intermittent vocal cord pareses in humans. Some authors use the term 'irritable larynx syndrome' (ILS) in a similar context. This article reviews the state of knowledge regarding LN and ILS and discusses the somewhat confusing terminology.For this systematic review a selective literature research in PubMed has been carried out...
October 2012: Laryngo- Rhino- Otologie
L Arick Forrest, Tiffany Husein, Omar Husein
Paradoxical vocal cord motion (PVCM), or vocal cord dysfunction, is a descriptive term for inappropriate adduction of the vocal folds during respiration. The laryngeal mistiming leads to breathing difficulty and is often misdiagnosed as refractory asthma. The etiology of PVCM has been unclear but has long been hypothesized to be psychological. The present thesis is a prospective study of 170 patients older than 18 years being evaluated for PVCM, with 117 of the 170 (68.8%) identified as having PVCM by video laryngoscopy...
April 2012: Laryngoscope
Caterina B Bucca, Massimiliano Bugiani, Beatrice Culla, Giuseppe Guida, Enrico Heffler, Sabrina Mietta, Antonella Moretto, Giovanni Rolla, Luisa Brussino
BACKGROUND: Perennial rhinitis (PR), chronic rhinosinusitis (CRS), or both, asthma, and gastroesophageal reflux disease (GERD) are the most frequent triggers of chronic cough (CC). Extrathoracic airway receptors might be involved in all 3 conditions because asthma is often associated with PR/CRS and gastroesophageal refluxate might reach the upper airway. We previously found that most patients with rhinosinusitis, postnasal drip, and pharyngolaryngitis show laryngeal hyperresponsiveness (LHR; ie, vocal cord adduction on histamine challenge) that is consistent with an irritable larynx...
February 2011: Journal of Allergy and Clinical Immunology
R F Hoy, M Ribeiro, J Anderson, S M Tarlo
BACKGROUND: Work-associated respiratory symptoms may be caused by disorders of both the lower and upper respiratory tract. We propose that occupational exposures may initiate and/or trigger recurrent hyperkinetic laryngeal symptoms, predominantly episodic dyspnoea, dysphonia, cough and sensation of tension in the throat-work-associated irritable larynx syndrome (WILS). AIMS: To examine characteristics of individual and work-related factors that are associated with WILS, occupational asthma (OA) and work-exacerbated asthma (WEA)...
October 2010: Occupational Medicine
A O Gamer, R Rossbacher, W Kaufmann, B van Ravenzwaay
Systemic and respiratory tract (RT) toxicity of triethanolamine (TEA) was assessed in a 28-day nose-only inhalation study in Wistar rats (10animals/sex, concentrations: 0, 20, 100, 500mg/m3; 5 days/week, 6h/day). In two nose-only 90-day inhalation studies, with similar exposure design, Wistar rats were exposed to 0, 15, 150, 400mg/m3 diethanolamine (DEA) (DEA Study 1:13animals/sex, general subchronic study) and to 0, 1.5, 3, 8mg/m3 (DEA Study 2:10animals/sex) to specifically investigate respiratory tract toxicity...
June 2008: Food and Chemical Toxicology
N Magnavita, P Bordignon, G Ciaffi, P Ferraro, F Vincenti
A 39 year male pharmaceutical worker employed in a clean-room developed in 2003 acute dysphonia after environmental disinfection with glutaric aldehyde and isopropyl alcohol. Laryngoscopic examination showed glottis edema; the syndrome healed after a cycle of cortisone. In subsequent years, withdrawal from exposure to irritating chemicals was observed. The worker, however, complained for recurrent episodes of dysphonia, in the absence of abnormalities of the larynx, and gradually developed intolerance for perfume, solvents, and other smelling substances...
July 2007: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Graiyna Doroszewska, Piotr Winiarski, Zbigniew Bartuzi
History of oral allergy syndrome goes back to 1987 year, when Amlot for the first time used this name for pollen-food cross-reactive reactions. Since that time many kinds of various reactions between pollens and different food had been described. Is seems that after almost 20 years the knowledge about this highly prevalent phenomenon is still incomplete and not well known among specialist other than allergologists. We try to reach consensus on several aspects of this food-induced syndrome, which may be helpful in laryngological practice...
2006: Otolaryngologia Polska
John Widdicombe, Ron Eccles, Giovanni Fontana
The evidence for supramedullary influences on cough is largely indirect. Cough can be voluntarily induced or inhibited, functions usually thought to reside in the cerebral cortex. A sensation of 'urge-to-cough' usually precedes cough due to an airway irritant stimulus, and this may well involve the cerebral cortex. In conditions with interruption of the pathways between the cortex and the brainstem, such as strokes and Parkinson's disease, voluntary cough may be inhibited without disruption of reflex cough from the larynx or lower airways...
July 28, 2006: Respiratory Physiology & Neurobiology
M V Andrianopoulos, G J Gallivan, K H Gallivan
Paroxysmal vocal cord movement/motion (PVCM), paroxysmal vocal cord dysfunction (PVCD), episodic paroxysmal laryngospasm (EPL), and irritable larynx syndrome (ILS) are terms used to describe laryngeal dysfunction masquerading as asthma, upper airway obstruction, or functional and organic voice disorders. The differential diagnosis of PVCM, PVCD, EPL, and ILS is critical to successful medical and behavioral management of the patient. During the past 10 years, 27 subjects, ages 15-79 years, were identified to have paroxysms of inspiratory stridor, acute respiratory distress, associated aphonia and dysphonia, resulting in misdiagnosis and unnecessary emergency treatments, including endotracheal intubation, cardiopulmonary resuscitation, massive pharmacotherapy, or tracheostomy...
December 2000: Journal of Voice: Official Journal of the Voice Foundation
M Morrison, L Rammage, A J Emami
Muscular tension dysphonia, episodic laryngospasm, globus, and cough may be considered to be hyperfunctional laryngeal symptoms. Suggested etiological factors for these symptoms include gastroesophageal reflux, psychological problems, and/or dystonia. We propose a unifying hypothesis that involves neural plastic change to brainstem laryngeal control networks through which each of the above etiologies, plus central nervous system viral illness, can play a role. We suggest that controlling neurons are held in a "spasm-ready" state and that symptoms may be triggered by various stimuli...
September 1999: Journal of Voice: Official Journal of the Voice Foundation
N Nandwani, R Caranza, C D Hanning
Upper airway reactivity was measured in 13 patients with obstructive sleep apnoea (OSA), using transient reflex laryngeal closure in response to dilute inhaled ammonia vapour. Upper airway reactivity was measured before and after 3 months of treatment with nasal continuous positive airway pressure (CPAP). Upper airway reactivity decreased significantly after treatment with nasal CPAP to values which were similar to those seen in normal subjects. We hypothesise that patients with OSA have increased upper airway reactivity, secondary to inflammation of the epithelial lining of the upper airway following the repeated injury of nocturnal airway obstruction, allowing the facilitated passage of inhaled irritants to the subepithelial receptors...
June 1998: Journal of Sleep Research
A H Campbell, R Pierce
We have analysed the clinical manifestations of nine patients with brief upper airway dysfunction (BUAD) who attended the thoracic department of a major teaching hospital between 1987 and 1991. Episodes of BUAD developed within 1-4 months of presentation in three patients but were undiagnosed for 2.5-12.5 years in six. The mean age at onset was 51 years ranging from 37 to 66 years. The episodes occurred at irregular intervals. They lasted approximately 1-5 min, were frightening and consisted of an initial phase of obstructive apneoa lasting a few seconds to 2 min and a second phase of respiratory distress with inspiratory stridor lasting 1-4 min...
February 1994: Respiratory Medicine
D H Downs, K Johnson, G S Goding
The laryngeal chemoreflex (LCR) consists of apnea, laryngospasm, and cardiovascular changes in neonates after laryngeal irritation and has been implicated in sudden infant death syndrome and apnea of infancy. Antihistamines attenuate a similar vagally mediated pulmonary chemoreflex. The intravenous antihistamine effect on the LCR was studied in neonatal piglets. Laryngeal muscle activity, respiration, blood pressure, and pulse were measured during water stimulation of the LCR. After baseline LCR recordings, intravenous diphenhydramine (2...
August 1995: Laryngoscope
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