Page 71 - Škrgat, Sabina, ed. 2022. Severe Asthma - Basic and Clinical Views. Koper: University of Primorska Press. Severe Asthma Forum, 1
P. 71
ng the youth with airway hyperrespon- so it was logical to use proton pump inhibi- 71
siveness, the prevalence of EILO was 26.1%8. tors, ranitidine, and antacids in those patients.
The success of such treatment is very good the char acteristics of upper respir atory tr act in the patients with asthma ...
Treatment in those patients in whom reflux has been
demonstrated38,34.
Team approach is necessary to treat patients
with ELO problems. When the correct diag- Surgical treatment also gives good re-
nosis is established with appropriate proce- sults, but only in selected patients. The most
dures, we can explain the events to the patient commonly used method is to cut the aryepi-
in the acute phase and calm him down. In glottic folds closer to the epiglottis and to re-
some patients, rapid “dog breathing” is suc- move the mucosa and cuneiform cartilage
cessful, in others a slow long breath through from the aryepiglottic fold with the help of a
the nose, in others an attempt to smell or pho- laser (supraglottoplasty). The use of a suture
nate a high voice / s / or a combination of that pulls the epiglottis towards the root of the
these two manoeuvres. Some patients are tongue and lateralization of one vocal cord
helped by speaking quickly, loudly, coughing, with a suture is also described28,51.
or holding their breath1. Some authors report
the success of diazepine therapy, while oth- Pinder and co-workers used a question-
er authors are not in favour of this method naire to determine the long-term course of the
of treating acute dyspnea1,9. Christopher and disease. After 15 years of ELO onset, none of
colleagues were the first to describe the imme- the patients reported deterioration. The con-
diate beneficial effect of inhaling a mixture of dition improved or completely recovered in
helium and oxygen during an attack, and the 68% of included subjects37.
effect of the treatment was not only acute but
also long-lasting10. Although ELO is benign Conclusions
in nature and difficulty breathing ceases af-
ter a period of time, cases have been described Respiratory tract acts as a whole. The same
where intubation or even tracheotomy was re- causes can induce asthma, rhinitis and laryn-
quired due to severe respiratory distress dur- gitis in some individuals. Some of the larynge-
ing the attack9. al characteristics of the asthma patients can be
just the result of asthma symptoms or asthma
So far, quite a few methods have been treatment. In others, there are different dis-
used in the treatment of recurrent problems eases manifesting the same symptoms of the
with varying degrees of success. Speech ther- upper respiratory tract. In some patients, dif-
apy treatment is based on breathing exercis- ferent pathologies coexist. Therefore, a team
es, exhalation against resistance, strengthen- of different specialists must be involved in
ing of inspiratory muscles and relaxation of the diagnostic procedures and the treatment
vocal cords9,7. Psychotherapy and counsel- of asthma, asthma – caused conditions, asth-
ling help in 30% to 90% of cases, greater suc- ma-accompanying diseases, and asthma-like
cesses are of course in the psychogenic form diseases of the upper respiratory tract.
of ELO. There are some reports of successful
use of hypnosis in the paediatric population3,9. References
Until a few years ago, experts believed 1. Adrianopoulus MV, Gallivan GJ, Gal-
that gastroesophageal reflux to the level of livan KH. PVCM, PVCD, EPL and ir-
the larynx and pharynx was the main cause ritable larynx syndrome: what are we
of ELO. This is the case in certain patients. talking about and how do we treat it? J
There are studies that have demonstrated Voice. 2000 Dec;14(4):607-18.
the presence of reflux in patients with ELO,
2. Aguilart D, Pinart M, Koppelman GH,
et al. Computational analysis of mul-
siveness, the prevalence of EILO was 26.1%8. tors, ranitidine, and antacids in those patients.
The success of such treatment is very good the char acteristics of upper respir atory tr act in the patients with asthma ...
Treatment in those patients in whom reflux has been
demonstrated38,34.
Team approach is necessary to treat patients
with ELO problems. When the correct diag- Surgical treatment also gives good re-
nosis is established with appropriate proce- sults, but only in selected patients. The most
dures, we can explain the events to the patient commonly used method is to cut the aryepi-
in the acute phase and calm him down. In glottic folds closer to the epiglottis and to re-
some patients, rapid “dog breathing” is suc- move the mucosa and cuneiform cartilage
cessful, in others a slow long breath through from the aryepiglottic fold with the help of a
the nose, in others an attempt to smell or pho- laser (supraglottoplasty). The use of a suture
nate a high voice / s / or a combination of that pulls the epiglottis towards the root of the
these two manoeuvres. Some patients are tongue and lateralization of one vocal cord
helped by speaking quickly, loudly, coughing, with a suture is also described28,51.
or holding their breath1. Some authors report
the success of diazepine therapy, while oth- Pinder and co-workers used a question-
er authors are not in favour of this method naire to determine the long-term course of the
of treating acute dyspnea1,9. Christopher and disease. After 15 years of ELO onset, none of
colleagues were the first to describe the imme- the patients reported deterioration. The con-
diate beneficial effect of inhaling a mixture of dition improved or completely recovered in
helium and oxygen during an attack, and the 68% of included subjects37.
effect of the treatment was not only acute but
also long-lasting10. Although ELO is benign Conclusions
in nature and difficulty breathing ceases af-
ter a period of time, cases have been described Respiratory tract acts as a whole. The same
where intubation or even tracheotomy was re- causes can induce asthma, rhinitis and laryn-
quired due to severe respiratory distress dur- gitis in some individuals. Some of the larynge-
ing the attack9. al characteristics of the asthma patients can be
just the result of asthma symptoms or asthma
So far, quite a few methods have been treatment. In others, there are different dis-
used in the treatment of recurrent problems eases manifesting the same symptoms of the
with varying degrees of success. Speech ther- upper respiratory tract. In some patients, dif-
apy treatment is based on breathing exercis- ferent pathologies coexist. Therefore, a team
es, exhalation against resistance, strengthen- of different specialists must be involved in
ing of inspiratory muscles and relaxation of the diagnostic procedures and the treatment
vocal cords9,7. Psychotherapy and counsel- of asthma, asthma – caused conditions, asth-
ling help in 30% to 90% of cases, greater suc- ma-accompanying diseases, and asthma-like
cesses are of course in the psychogenic form diseases of the upper respiratory tract.
of ELO. There are some reports of successful
use of hypnosis in the paediatric population3,9. References
Until a few years ago, experts believed 1. Adrianopoulus MV, Gallivan GJ, Gal-
that gastroesophageal reflux to the level of livan KH. PVCM, PVCD, EPL and ir-
the larynx and pharynx was the main cause ritable larynx syndrome: what are we
of ELO. This is the case in certain patients. talking about and how do we treat it? J
There are studies that have demonstrated Voice. 2000 Dec;14(4):607-18.
the presence of reflux in patients with ELO,
2. Aguilart D, Pinart M, Koppelman GH,
et al. Computational analysis of mul-
