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Refluxo laringo-faríngeo : as nuances em ORL e a sua relação com o tabaco
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A laringe é um dos locais do corpo humano cujas agressões sofridas têm vindo gradualmente a aumentar com o avançar dos tempos, sendo o refluxo laringo-faríngeo uma condição em franco crescimento. O tabagismo, presente na história mundial há longo, é também um potenciador de lesão laríngea e de refluxo, assim como dos seus efeitos, atingindo especialmente os mecanismos de defesa naturais da laringe. A variedade da sua manifestação e a partilha de sinais e sintomas com outras patologias leva a que seja importante a especial atenção ao seu diagnóstico, devendo ser usadas escalas, principalmente o RSI e RFS, em observações de rotina, de forma a se averiguar a probabilidade da existência do problema e de o identificar o mais precocemente possível. Os seus efeitos na diminuição de qualidade de vida são significativos, atingindo especialmente os profissionais da voz, ficando menos aptos a usá-la tão eximiamente.
Relativamente à gestão da doença, esta requer cuidados continuados e prolongados. A resposta à terapêutica apresenta inconsistências, sendo a sua eficácia por vezes insatisfatória, sendo os IBPs a base, podendo serem alternados entre eles. Requer uma abordagem multidisciplinar, variável e adaptada a cada circunstância, sendo especialmente importante a educação do paciente relativamente à patologia. As mudanças de estilo de vida, incluindo a cessação tabágica, são essenciais para o controlo da doença, factores muitas vezes desprezados. Assim, é importante a investigação de formas mais eficazes de alerta sobre os efeitos do tabagismo e de que forma se pode controlar melhor a doença.
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Pesquisa de artigos na base de dados Pubmed, recorrendo às palavras-chave abaixo mencionadas, com exclusão de artigos sem ser em língua inglesa, escolhendo-se artigos acima do ano 1990. Usou-se o software Mendeley para a elaboração das referências do texto. Legendas das imagens traduzidas literalmente dos artigos originais para Português.
The larynx is one of the body parts which have been increasingly susceptible to damage over the years, with the laryngo pharyngeal reflux as a frankly growing condition. Tabagism, with a long-standing record in historical pages, is also a strong promoter of laryngeal lesions and reflux itself, as well as of its consequences, notably affecting the laryngeal natural defence mechanisms. The variability of manifestations and the signs and symptoms resemblance with other pathologies cause a particularly important need for special attention to its diagnostic, making several scores a must use tool in routine observations, such as the RSI and the RFS, with the goal of evaluating the likeliness of the presence of disease and, in such case, an early identification. The consequences regarding the decreased life quality are significant, notably in voice professional users, decreasing their ability to use it as well. Concerning the disease management, it requires continued and prolonged care. The response to therapeutics is not always favourable, revealing unsatisfactory effectiveness, with the PPIs as the main cornerstone of treatment, which can be interchanged between them. An adapted and versatile multidisciplinary approach should be used from case to case, and patient education regarding the disease should be carefully focused. Lifestyle changes, let alone smoking cessation, are critical for managing signals and symptoms, as well as the disease itself, and should not be disregarded. Thus, it is crucial to research more effective means to raise awareness concerning smoking habits and to improve disease management.
The larynx is one of the body parts which have been increasingly susceptible to damage over the years, with the laryngo pharyngeal reflux as a frankly growing condition. Tabagism, with a long-standing record in historical pages, is also a strong promoter of laryngeal lesions and reflux itself, as well as of its consequences, notably affecting the laryngeal natural defence mechanisms. The variability of manifestations and the signs and symptoms resemblance with other pathologies cause a particularly important need for special attention to its diagnostic, making several scores a must use tool in routine observations, such as the RSI and the RFS, with the goal of evaluating the likeliness of the presence of disease and, in such case, an early identification. The consequences regarding the decreased life quality are significant, notably in voice professional users, decreasing their ability to use it as well. Concerning the disease management, it requires continued and prolonged care. The response to therapeutics is not always favourable, revealing unsatisfactory effectiveness, with the PPIs as the main cornerstone of treatment, which can be interchanged between them. An adapted and versatile multidisciplinary approach should be used from case to case, and patient education regarding the disease should be carefully focused. Lifestyle changes, let alone smoking cessation, are critical for managing signals and symptoms, as well as the disease itself, and should not be disregarded. Thus, it is crucial to research more effective means to raise awareness concerning smoking habits and to improve disease management.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Refluxo laringo-faríngeo Tabaco Tabagismo e refluxo em otorrinolaringologia Mudanças na qualidade de vida com refluxo laringo-faríngeo