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Exercise-Induced Laryngeal Obstruction

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Textbook of Surgery of Larynx and Trachea

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Abstract

Exercise-induced laryngeal obstruction (EILO) is an umbrella term describing a dynamic closure of laryngeal structures during exercise, causing breathing problems. Recent population studies have shown that EILO is a relatively prevalent entity, most often affecting adolescents or young adults. EILO typically causes inspiratory symptoms and may have considerable functional impact on physical activity. Visualization of the laryngeal lumen during exercise is important for classification (i.e., glottic or supraglottic) and subsequent treatment planning. The continuous laryngoscopy exercise (CLE) test is therefore a useful tool in the evaluation of EILO patients. Information about the diagnosis and demonstration of the CLE test video often has a reassuring effect, and the differential diagnosis toward asthma is important. Small studies and case reports indicate effect from speech therapy, biofeedback, and inspiratory muscle training. Robust treatment algorithms and follow-up based on proper patient selection should be established. Supraglottic EILO is characterized as folding of the aryepiglottic folds comparable to that observed in infants with congenital laryngomalacia (CLM). This observation has encouraged surgeons to treat supraglottic EILO with supraglottoplasty. Although this procedure is proven efficient and safe, it is irreversible with potential risks for complication and should be restricted to selected cases.

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Notes

  1. 1.

    If the inducer is exercise, the suggested term is exercise-induced laryngeal obstruction (EILO).

  2. 2.

    The circumstances for the diagnostic laryngoscopy should be described and findings reported in detail for sub-categorization, e.g., laryngeal level of obstruction (supraglottic, glottic, or a combination of both).

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Author information

Authors and Affiliations

  1. Department of Surgery, Haukeland University Hospital, Bergen University, Bergen, Norway

    John-Helge Heimdal

  2. Department of Otorhinolaryngology Head and Neck Surgery, Haukeland University Hospital, Bergen University, Bergen, Norway

    John-Helge Heimdal

  3. Department of Otolaryngology, Saxenburgh Medical Center, Hardenberg, The Netherlands

    Robert Maat

  4. Department of Otolaryngology, Haukeland University Hospital, Bergen, Norway

    Magnus Hilland

  5. Department of Surgical Sciences, Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden

    Leif Nordang

Authors
  1. John-Helge Heimdal
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  2. Robert Maat
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  3. Magnus Hilland
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  4. Leif Nordang
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Correspondence to John-Helge Heimdal .

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Editors and Affiliations

  1. Department of Oto-Rhino-Laryngology, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg

    Marc Remacle

  2. Department of Oto-Rhino-Laryngology, A.ö. Landeskrankenhaus Klagenfurt, HNO, Klagenfurt, Austria

    Hans Edmund Eckel

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Heimdal, JH., Maat, R., Hilland, M., Nordang, L. (2022). Exercise-Induced Laryngeal Obstruction. In: Remacle, M., Eckel, H.E. (eds) Textbook of Surgery of Larynx and Trachea. Springer, Cham. https://doi.org/10.1007/978-3-031-09621-1_11

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