难治性慢性咳嗽:耳鼻喉科医生的最新研究综述》。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Gabriela L Lilly, Thomas Carroll, Kristine Pietsch, Vaninder Dhillon, Paul C Bryson, Lee M Akst
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引用次数: 0

摘要

目的:在耳鼻喉科门诊中,难治性慢性咳嗽(RCC)患者越来越多。对于已接受胃食管反流、鼻窦疾病、肺部疾病和血管紧张素转换酶抑制剂相关咳嗽一线治疗的患者,确定下一步的咳嗽评估和管理至关重要。这篇最新综述从耳鼻喉科的角度重点介绍了 RCC 的新兴治疗方法:Pubmed.综述方法:回顾并总结了有关慢性咳嗽的现有文献,重点关注 RCC、病理生理学的新范例以及不断发展的治疗方法:结论:在对难治性咳嗽生理学有了更详细了解的指导下,已开发出大量治疗 RCC 的新方法。这些治疗方法的主要目的是通过抑制感觉输入或改变运动活动来破坏被认为是超敏的咳嗽反射,包括神经调节剂治疗、喉上神经阻断、声带增强、肉毒杆菌毒素注射、局部使用辣椒素以及最终可能使用的 P2X3 拮抗剂。此外,还讨论了喉咽反流诊断和管理的改进以及行为止咳疗法的潜在益处:支持这些策略的文献越来越多,随着越来越多的 RCC 患者寻求耳鼻喉科治疗,了解这些不同的方法可能会改善这种疾病的整体治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Refractory Chronic Cough: A State-of-the-Art Review for Otolaryngologists.

Objective: Patients with refractory chronic cough (RCC) are being seen in increasing numbers within otolaryngology clinics. Identifying the next steps in the evaluation and management of cough in patients who have had first-line treatment for gastroesophageal reflux, sinonasal disease, pulmonary disease, and angiotensin-converting enzyme inhibitor-related cough is paramount. This state-of-the-art review focuses on emerging treatments for RCC from an otolaryngology perspective.

Data sources: Pubmed.

Review methods: The available literature on chronic cough, with a focus on RCC, emerging paradigms concerning pathophysiology, and evolving treatment approaches was reviewed and summarized.

Conclusions: Guided by a more detailed understanding of refractory cough physiology, a myriad of new treatment options have been developed to treat RCC. These are primarily aimed at disrupting what is thought to be a hypersensitive cough reflex, whether by a dampening of its sensory inputs or an alteration in motor activity, and are inclusive of neuromodulator treatments, superior laryngeal nerve blockade, vocal fold augmentation, botulinum toxin injection, topical capsaicin, and potentially the eventual use of P2X3 antagonists. Improved laryngopharyngeal reflux diagnosis and management, as well as the potential benefit of behavioral cough suppression therapy, are also discussed.

Implications for practice: The literature supporting each of these strategies is growing-and as more patients with RCC seek otolaryngology care, knowledge of these various approaches may improve the overall treatment of this condition.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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