Buscar en
Acta Otorrinolaringológica Española
Toda la web
Inicio Acta Otorrinolaringológica Española Hiccups. Attitude in Otorhinolaryngology Towards Consulting Patients. A Diagnost...
Journal Information
Vol. 68. Issue 2.
Pages 98-105 (March - April 2017)
Share
Share
Download PDF
More article options
Visits
937
Vol. 68. Issue 2.
Pages 98-105 (March - April 2017)
Original article
Hiccups. Attitude in Otorhinolaryngology Towards Consulting Patients. A Diagnostic and Therapeutic Approach
Hipo. Actitud en otorrinolaringología en pacientes que consultan. Aproximación diagnóstica y terapéutica
Visits
937
Francisco Javier García Callejoa,
Corresponding author
jgarciacall@hotmail.com

Corresponding author.
, Jaume Redondo Martíneza, Tomás Pérez Carbonella, Rafael Monzó Gandíab, M. Paz Martínez Beneytoa, Inés Rincón Piedrahitaa
a Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Valencia, Spain
b Servicio de Otorrinolaringología, Hospital General de Requena, Requena, Valencia, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (2)
Table 1. Epidemiological Traits, Diagnoses and Treatments Established for the Patients Included in the Study.
Table 2. Aetiological Possibilities of Hiccups.
Show moreShow less
Abstract
Introduction

Hiccup crises are generally benign and self-limiting, but longer episodes affect quality of life and must be treated. There are recognisable causes that otorhinolaryngologists must know and be aware for diagnosis and therapeutic alternatives. The main expression is a spasmodic glottic noise with characteristic neck alterations.

Patients and methods

This was a retrospective study from 1979 with patients suffering persistent or recurrent hiccups. Chronobiology, comorbidity, findings from explorations, therapies and outcomes were noted. Thirty-seven patients were studied (mean age, 45.5±13.5 years; 30 males), with persistent hiccups in 23 (62%).

Results

A potential associated aetiology was observed in 24 cases (65%): oesophageal disorders–mainly gastroesophageal reflux–were detected in 14 cases and concomitant oncological disease was found in 8. Only 3 cases were admitted for surgery due to these findings. Therapeutic strategies with metoclopramide were used in 18 subjects, chlorpromazine in 17 and baclofen in 13, while carbamazepine or haloperidol were used in a minority. Phrenic nerve stimulation was employed in 6 patients. Hiccups disappeared in 32 cases. Out of 22 cases for which follow-up was possible, the hiccups recurred in 5 subjects (the subjects requiring new therapies) and 11 patients died.

Conclusions

Chronic hiccup represents a multidisciplinary challenge that includes potential head and neck affection, a diagnostic schedule for ruling out causes, frequent base oesophageal alterations and high incidence of malignant neoplasm. Prokinetic and neuroleptic agents with antidopaminergic and anticholinergic effects are the pillars of its treatment.

Keywords:
Hiccup
Aetiology
Diagnostic
Therapy
Resumen
Introducción

Las crisis de hipo suelen ser autolimitadas y benignas, pero los episodios prolongados alteran la calidad de vida y requieren asistencia, ya que existen causas identificables que el otorrinolaringólogo debe conocer para su diagnóstico y tratamiento. Su manifestación última es un ruido glótico espasmódico con alteraciones cervicales características.

Pacientes y métodos

Desde 1979 se revisaron todos los casos que consultaron por hipo persistente o recidivante, anotando cronobiología, patología concomitante, resultados de las exploraciones, tratamiento y respuestas al mismo.

Resultados

Se asistieron 37 pacientes con una edad media de 45,5±13,5 años, de los cuales 30 eran varones; 23 pacientes (el 62%) presentaron hipo persistente. En 24 casos (el 65%) se evidenció una causa potencialmente asociable: enfermedades del esófago en 14 —la mayoría reflujo gastroesofágico— y en 8 se apreció o descubrió patología oncológica concomitante. Solo 3 casos fueron intervenidos como resultado de los hallazgos efectuados. Los protocolos de tratamiento incluyeron metoclopramida en 18 sujetos, clorpromazina en 17 y baclofeno en 13, pero también carbamazepina o haloperidol. Se empleó neuroestimulación del nervio frénico en 6 pacientes. El hipo desapareció en 32 casos. De los 22 sujetos en los que se pudo efectuar seguimiento, se constató recidiva en 5 —precisando por ello nuevas terapias— y 11 fallecieron.

Conclusiones

El hipo crónico implica un reto multidisciplinar con potencial afectación en cabeza y cuello, una sistemática diagnóstica de descarte, frecuente patología de base esofágica y una incidencia de neoplasia maligna alta. Los agentes procinéticos y neurolépticos con efecto antidopaminérgico y anticolinérgico suponen la base del tratamiento.

Palabras clave:
Hipo
Etiología
Diagnóstico
Tratamiento

Article

These are the options to access the full texts of the publication Acta Otorrinolaringológica Española
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Acta Otorrinolaringológica Española

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Quizás le interese:
10.1016/j.otoeng.2019.02.002
No mostrar más