[Otolaryngological-Speech Therapy approach to laryngeal neuropathy in children]. / Abordaje otorrinolaringológico-fonoaudiológico de la neuropatía laríngea en la edad pediátrica.

Laryngeal neuropathy (LN) is characterized by hypersensitivity, hyperresponsiveness, and laryngeal hyperfunction secondary to an imbalance between the afferent and efferent components. The indi vidual and exaggerated response to a wide variety of specific triggers can lead to diverse symptoms. Literature in children is limited. OBJECTIVE: To report a case of laryngeal neuropathy in a 5-year- old girl, to discuss the approach from the otolaryngologist's and speech therapist's perspective and the importance of its consideration among the differential diagnoses of chronic cough in pediatrics. CLINICAL CASE: 5-year-old girl referred to otorhinolaryngology due to repeated crises of emetic cough with no specific cause identified. The episodes were associated with colds, choking sensation, and short-term inspiratory stridor. She was evaluated by several specialties. X-rays (nasopharynx, para nasal sinuses, and chest) and spirometry were performed without finding a cause or treatment that resolved the cough. In the ENT evaluation, possible triggers were identified such as having a sister with a congenital syndrome, exposure to perfumes, and air fresheners. Physical examination was normal. Flexible endoscopy shows incipient vocal fold nodules. After clinical suspicion of LN, she was referred to speech therapy for 5 weekly sessions. The patient received vocal hygiene education, cough suppression techniques, and breathing and relaxation exercises of the extrinsic and intrinsic muscles of the larynx with favorable results at 2 years of follow-up. CONCLUSIONS: LN should be con sidered as a differential diagnosis of chronic cough in childhood when its most well-known causes and treatments do not lead to its resolution. The evaluation and speech therapy are the mainstay in the control of cough secondary to this entity in the pediatric age.

Sistematización en el proceso de evaluación y terapia del pólipo de cuerda vocal: encuesta a médicos otorrinolaringólogos chilenos / Assessment and therapy process systematization of vocal fold polyps: a survey to Chilean otorhynolaryngologists

Esta investigación tiene por propósito describir las indicaciones terapéuticas, prescritas por médicos otorrinolaringólogos a pacientes diagnosticados con pólipo cordal. Se describen las etapas de evaluación, reposo vocal e indicaciones terapéuticas. El estudio intenta develar la presencia de una sistematización en el proceso anterior. Dicha información es recabada a partir de una encuesta vía mail aplicada a 29 médicos pertenecientes a la Sociedad Chilena de Otorrinolaringología (N=205). Los datos obtenidos permiten concluir que no existe un estándar en las indicaciones que se preguntan en la encuesta. Sin embargo, el total de médicos consultados manifiesta que sería útil la elaboración de protocolos para la evaluación y tratamiento de los pacientes con alteración vocal.

This research is aimed at describing the therapeutic indications, prescribed by otorhynolaryngologists polyp patients diagnosed with tailpiece, including assessment, voice rest and therapeutic indications. The study attempts to reveal the presence of systematization in the previous process. This information is collected from a survey via e-mail applied to 29 physicians belonging to the Chilean Society of Otolaryngology (n =205). The data obtained indicate that there is no standard in the information asked for in the survey. However, the total number of doctors surveyed stated that the development of protocols for assessment and treatment of patients with vocal alteration would be useful.