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DOI: 10.1055/s-0032-1312615
Laryngeale Neuropathie und „irritable larynx syndrome“: Synonyme oder differente Entitäten?
‘Laryngeal Neuropathy’ and ‘Irritable Larynx Syndrome’: Synonyms or Distinct Entities?Publikationsverlauf
Publikationsdatum:
25. Mai 2012 (online)
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Zusammenfassung
Hintergrund:
Der Begriff „laryngeale Neuropathie“ (LN) wurde erstmalig in der Veterinärmedizin für die idiopathische, typischerweise mit einem belastungsabhängigen Inspirationsgeräusch einhergehende Parese des N. laryngeus inferior bei Pferden, verwendet. Mittlerweile findet sich der Begriff der LN auch in der Humanmedizin, allerdings eher im Zusammenhang mit einer intermittierenden Stimmlippenbeweglichkeitsstörung. Andere Autoren verwenden für eine ähnliche Symptomatik den Begriff „irritable larynx syndrome“ (ILS). Hier soll anhand einer Literaturrecherche der aktuelle Kenntnisstand zur LN und ILS aufgearbeitet werden.
Methodik:
Übersichtsarbeit nach selektiver Literaturrecherche in PubMed.
Ergebnisse:
Es fanden sich 35 Arbeiten im Bereich der Tiermedizin und 17 Arbeiten im Bereich der Humanmedizin, davon 4 über das „irritable larynx syndrome“.
Diskussion:
Die LN betrifft bei Pferden fast ausschließlich den linken N. laryngeus inferior, beruht auf einer distalen Axonopathie und führt i. d. R. zu einer Einschränkung der Stimmlippen-Abduktionsbewegung und einem konsekutiven Inspirationsgeräusch, insbesondere bei körperlicher Belastung (Galopp). Bei Hunden tritt die LN auch beidseitig auf. In den relativ wenigen humanmedizinischen Publikationen zur LN wird der Begriff deutlich weniger scharf definiert verwendet.
Der Begriff „irritable larynx syndrome“ findet sich ausschließlich in der humanmedizinischen Literatur. Mit ILS soll eine Überempfindlichkeit laryngealer Strukturen gegen äußere Reize, die ebenfalls zu einer Dyspnoe, aber auch anderen Symptomen wie Husten usw. führen kann, bezeichnet werden.
Der aktuelle Forschungsstand sowohl zur LN als auch zum ILS ist letztlich unbefriedigend. Daher bietet es sich in der Humanmedizin derzeit nicht an, bei entsprechender Symptomatik unklarer Ätiologie von einer LN zu sprechen, es sollte besser der Begriff laryngeale Bewegungsstörung für Einschränkungen der Stimmlippenbeweglichkeit verwendet werden. Mit dem deskriptiven Begriff „irritable larynx syndrome“ kann sicher zutreffend eine laryngeale Überempfindlichkeit benannt werden.
Abstract
Laryngeal Neuropathy’ and ‘Irritable Larynx Syndrome’: Synonyms or Distinct Entities
Background:
The term ‘laryngeal neuropathy’ (LN) has first been used in veterinary medicine to describe an idiopathic and typically exercise induced inspiratory noise in horses.
Nowadays, the term is often used in relation with intermittent vocal cord pareses in humans. Some authors use the term ‘irritable larynx syndrome’ (ILS) in a similar context. This article reviews the state of knowledge regarding LN and ILS and discusses the somewhat confusing terminology.
Method:
For this systematic review a selective literature research in PubMed has been carried out.
Results:
35 articles were found, which report on LN in animals and 17 articles reported on humans. 4 of these articles used the term ‘irritable larynx syndrome’.
Discussion:
Laryngeal neuropathy in horses usually affects the left recurrent laryngeal nerve and results in decreased vocal cord abduction and an inspiratory roaring or whistling noise, particularly during exercise. In dogs LN has been reported to also occur bilaterally. In association with humans LN has not been defined clearly in the literature. The term ILS on the other hand has only been used in relation to humans. The term describes a hypersensitivity of the laryngeal structures towards external stimuli, which causes symptoms such as dyspnea or cough among others. Sufficient knowledge does not exist for either of the 2 diseases, ILS or LN. As of yet, the term LN should not be used in human medicine to describe according symptoms of unknown aetiology. The term ‘laryngeal movement disorder’ seems a lot more appropriate. The symptom oriented term irritable larynx syndrome also seems suitable to describe laryngeal hypersensitivity appropriately.
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