The irritable larynx syndrome

Area of Science:

• Neurology
• Otolaryngology
• Speech Pathology

Background:

• Hyperfunctional laryngeal symptoms, including muscular tension dysphonia, episodic laryngospasm, globus, and chronic cough, are common.
• Etiological factors are diverse, often including gastroesophageal reflux, psychological issues, and dystonia.

Purpose of the Study:

• To propose a unifying hypothesis for hyperfunctional laryngeal symptoms.
• To investigate the role of neural plasticity in the brainstem's laryngeal control networks.
• To define criteria for Irritable Larynx Syndrome (ILS).

Main Methods:

• Studied 39 patients diagnosed with Irritable Larynx Syndrome based on specific inclusion criteria.
• Assessed etiological factors such as gastroesophageal reflux, psychological conditions, and history of viral illness.
• Proposed a hypothesis involving neural plastic changes in brainstem laryngeal control networks.

Main Results:

• Gastroesophageal reflux was implicated in over 90% of patients.
• Psychological factors were identified in approximately one-third of patients.
• One-third of patients linked symptom onset to a viral illness, suggesting potential central nervous system changes.

Conclusions:

• A unifying hypothesis suggests neural plastic changes in brainstem nuclei underlie hyperkinetic laryngeal dysfunction (Irritable Larynx Syndrome).
• This hypothesis integrates various etiologies and provides a framework for therapy and research.
• The findings support the concept of a "spasm-ready" state in laryngeal control neurons triggered by stimuli.