The role of serial physical examinations in the management of angioedema involving the head and neck:A prospective observational study

摘要

Objective:To elucidate the progression of angioedema of the head and neck with routine management and to assess the utility of serial physical exams and fiberoptic laryngos-copy in its management. Methods:This study was a prospective observational research. From 2013 to 2014, a prospec-tive observational study was conducted at a tertiary referral center. Forty patient were ap-proached, 7 refused, 33 (18e90 years old) were enrolled. Patients presented with angioedema involving the head and neck over a 12 month period were asked to participate in the study. Physical examination and fiberoptic laryngoscopy were performed at presentation and then repeated at least 1 h later. Results:Thirty-three patients with head and neck angioedema from any cause were enrolled (mean age 58, range 23e89 years). The upper lip was the most commonly involved site (58%). On reevaluation, 82% of patients reported subjective improvement in symptoms. Theassociation between subjective improvement and the physical exam, including fiberoptic laryngoscopy findings, was statistically significant (P<0.001). Conclusion:In stable patients with angioedema of any head and neck subsite, self-reported symptoms are associated with clinical stability or improvement as assessed by physical signs and fiberoptic laryngoscopy. Patients’ symptoms may be an appropriate surrogate to monitor clinical status without the need for routine serial physical examinations or fiberoptic laryngos-copy, though further study is needed. Copyright ª 2016 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).