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Work-associated irritable larynx syndrome.

Jennifer A Anderson1

  • 1Voice Disorders Clinic, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

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Work-associated irritable larynx syndrome (WILS) involves laryngeal symptoms from occupational irritants. Treatment involves environmental changes, GERD therapy, and behavioral or psychotherapy interventions.

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Area of Science:

  • Occupational Medicine
  • Laryngology
  • Pulmonology

Background:

  • Work-associated irritable larynx syndrome (WILS) is a hyperkinetic laryngeal disorder.
  • It stems from occupational irritant exposure and presents with varied symptoms like dysphonia, cough, dyspnea, and globus pharyngeus.
  • WILS can be challenging to distinguish from asthma, necessitating a thorough differential diagnosis.

Purpose of the Study:

  • To conduct a literature review on work-associated irritable larynx syndrome (WILS).
  • To explore the clinical presentation, pathophysiology, and management of WILS.
  • To differentiate WILS from other conditions like asthma.

Main Methods:

  • Literature review of studies on WILS and related laryngeal disorders.
  • Analysis of clinical symptoms, diagnostic challenges, and treatment modalities.
  • Synthesis of current understanding regarding WILS pathophysiology.

Main Results:

  • Laryngeal symptoms linked to airborne irritants are described under various labels, including WILS, vocal cord dysfunction (VCD), and laryngeal hypersensitivity.
  • The pathophysiology of WILS is not fully understood but appears multifactorial.
  • Emerging evidence suggests contributions from central neuronal plasticity, inflammation, and psychological factors.

Conclusions:

  • Potential WILS mechanisms include central neuronal plasticity post-exposure/infection, inflammation (e.g., GERD), and patient-specific psychological factors.
  • Treatment is individualized, often combining workplace environmental modifications, GERD management, speech therapy, psychotherapy, and neural modifiers.