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Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO).
Eur Arch Otorhinolaryngol. 2016 Apr; 273(4):945-51.EA

Abstract

Breathing difficulties during exertion may be caused by exercise-induced laryngeal obstruction (EILO). The diagnosis depends on visualization of the larynx during exercise, i.e. by continuous laryngoscopic exercise (CLE) test. In case of severe supraglottic collapse and pronounced symptoms during strenuous exertion, surgical treatment (supraglottoplasty) has been suggested. The aims of this study were to evaluate outcome and patient satisfaction after supraglottoplasty for EILO and to compare our results with previously reported data. During the period December 2010 to October 2013, 17 patients diagnosed with moderate to severe supraglottic EILO were treated by supraglottoplasty with microlaryngoscopic laser technique at our institutions. The severity of patients symptoms (VAS score) and CLE scores was evaluated pre- and postoperatively. We found a decrease in patients symptoms from median 80 points VAS score preoperatively to 20 points postoperatively (p < 0.001) and a decrease in CLE sum score from median 4.0 points to 2.5 points (p < 0.05). Several previous studies have recommended surgery for selected patients with supraglottic involvement, but these have mainly been based on case reports or on very few patients. This study is the second larger-scale study that documents the positive effect of supraglottoplasty as treatment of EILO in terms of reduced respiratory symptoms and decreased laryngeal obstruction assessed by post-operative CLE test. We suggest that surgery is a well-tolerated and effective treatment option for selected EILO patients with moderate to severe supraglottic obstruction during exercise and a high level of physical activity.

Authors+Show Affiliations

Department of ORL, Head and Neck Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark. camilla.mehlum@rsyd.dk.Department of Respiratory Medicine, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen K, Denmark.Department of ORL, Head and Neck Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.Department of Respiratory Medicine, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen K, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26541712

Citation

Mehlum, Camilla Slot, et al. "Supraglottoplasty as Treatment of Exercise Induced Laryngeal Obstruction (EILO)." European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, vol. 273, no. 4, 2016, pp. 945-51.
Mehlum CS, Walsted ES, Godballe C, et al. Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO). Eur Arch Otorhinolaryngol. 2016;273(4):945-51.
Mehlum, C. S., Walsted, E. S., Godballe, C., & Backer, V. (2016). Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO). European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 273(4), 945-51. https://doi.org/10.1007/s00405-015-3823-2
Mehlum CS, et al. Supraglottoplasty as Treatment of Exercise Induced Laryngeal Obstruction (EILO). Eur Arch Otorhinolaryngol. 2016;273(4):945-51. PubMed PMID: 26541712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO). AU - Mehlum,Camilla Slot, AU - Walsted,Emil Schwarz, AU - Godballe,Christian, AU - Backer,Vibeke, Y1 - 2015/11/05/ PY - 2015/06/21/received PY - 2015/10/29/accepted PY - 2015/11/7/entrez PY - 2015/11/7/pubmed PY - 2016/11/1/medline KW - Exercise-induced laryngeal obstruction KW - Supraglottoplasty KW - Surgery KW - Treatment SP - 945 EP - 51 JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JO - Eur Arch Otorhinolaryngol VL - 273 IS - 4 N2 - Breathing difficulties during exertion may be caused by exercise-induced laryngeal obstruction (EILO). The diagnosis depends on visualization of the larynx during exercise, i.e. by continuous laryngoscopic exercise (CLE) test. In case of severe supraglottic collapse and pronounced symptoms during strenuous exertion, surgical treatment (supraglottoplasty) has been suggested. The aims of this study were to evaluate outcome and patient satisfaction after supraglottoplasty for EILO and to compare our results with previously reported data. During the period December 2010 to October 2013, 17 patients diagnosed with moderate to severe supraglottic EILO were treated by supraglottoplasty with microlaryngoscopic laser technique at our institutions. The severity of patients symptoms (VAS score) and CLE scores was evaluated pre- and postoperatively. We found a decrease in patients symptoms from median 80 points VAS score preoperatively to 20 points postoperatively (p < 0.001) and a decrease in CLE sum score from median 4.0 points to 2.5 points (p < 0.05). Several previous studies have recommended surgery for selected patients with supraglottic involvement, but these have mainly been based on case reports or on very few patients. This study is the second larger-scale study that documents the positive effect of supraglottoplasty as treatment of EILO in terms of reduced respiratory symptoms and decreased laryngeal obstruction assessed by post-operative CLE test. We suggest that surgery is a well-tolerated and effective treatment option for selected EILO patients with moderate to severe supraglottic obstruction during exercise and a high level of physical activity. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/26541712/Supraglottoplasty_as_treatment_of_exercise_induced_laryngeal_obstruction__EILO__ L2 - https://dx.doi.org/10.1007/s00405-015-3823-2 DB - PRIME DP - Unbound Medicine ER -