title: Laryngeal Dysfunction: Assessment and Management for the Clinician.
abstract: The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation. In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute to the development of symptoms that appear "refractory" to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g., inducible laryngeal obstruction), voice disturbance, and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward, however, and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some time. This review provides an overview of the current state of knowledge in the field of laryngeal dysfunction, with a focus on pragmatic clinical assessment and management.
authors: 1 Department of Respiratory Medicine, Respiratory Biomedical Research Unit, Royal Brompton & Harefield National Health Service Foundation Trust, London, United Kingdom.
authors: James H
authors: JH
authors: Hull
authors: 2 Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
authors: Vibeke
authors: V
authors: Backer
authors: 3 Centre for Healthy Lungs, University of Newcastle, Newcastle, United Kingdom.|4 Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, United Kingdom.|5 Hunter Medical Research Institute, Newcastle, Australia.
authors: Peter G
authors: PG
authors: Gibson
authors: 6 Centre for Respiratory Medicine and Allergy, University of Manchester, Manchester, United Kingdom; and.|7 Manchester Academic Health Science Centre, Manchester, United Kingdom.
authors: Stephen J
authors: SJ
authors: Fowler
mesh_terms: D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology
keywords: cough; dyspnea; larynx; vocal; wheeze