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Exercise induced laryngeal obstruction: a review of diagnosis and management.
Eur Arch Otorhinolaryngol. 2017 04; 274(4):1781-1789.EA

Abstract

Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used. Primary searching found 469 records, 308 were excluded following screening of titles and citation. 100 were duplicates, a further 47 studies were excluded after applying inclusion and exclusion criteria. Two studies were identified following cross-referencing. A total of 15 studies were included. The last search date was 6/06/15. Average prevalence in the general adolescent population and athletes was 7.1 and 35.2 %, respectively. Dyspnoea was reported in 96.5, 99 and 100 % of three EILO patient cohorts. Two studies (n = 107) reported continuous laryngoscopy during exercise (CLE) testing could differentiate between patients and controls. In two studies (n = 33) the visual analogue scale (VAS) showed a beneficial effect of endoscopic supraglottoplasty (ES). Thirty-eight out of 43 patients who received two or more laryngeal control therapy sessions (LCT) had improvement or resolution of EILO symptoms. Exercise induced dyspnoea is the most common EILO symptom. EILO has a high occurrence in adolescents and athletes. The CLE test is the current gold standard for EILO diagnostics. Management of EILO includes both surgical and non-surgical interventions.

Authors+Show Affiliations

Cardiff University School of Medicine, Cardiff, UK.Cardiff University School of Medicine, Cardiff, UK.ENT Department, University Hospital Wales, Cardiff, UK. hassanelhassan@gmail.com.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

27730324

Citation

Liyanagedera, Savinda, et al. "Exercise Induced Laryngeal Obstruction: a Review of Diagnosis and Management." 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. 274, no. 4, 2017, pp. 1781-1789.
Liyanagedera S, McLeod R, Elhassan HA. Exercise induced laryngeal obstruction: a review of diagnosis and management. Eur Arch Otorhinolaryngol. 2017;274(4):1781-1789.
Liyanagedera, S., McLeod, R., & Elhassan, H. A. (2017). Exercise induced laryngeal obstruction: a review of diagnosis and management. 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, 274(4), 1781-1789. https://doi.org/10.1007/s00405-016-4338-1
Liyanagedera S, McLeod R, Elhassan HA. Exercise Induced Laryngeal Obstruction: a Review of Diagnosis and Management. Eur Arch Otorhinolaryngol. 2017;274(4):1781-1789. PubMed PMID: 27730324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exercise induced laryngeal obstruction: a review of diagnosis and management. AU - Liyanagedera,Savinda, AU - McLeod,Robert, AU - Elhassan,Hassan A, Y1 - 2016/10/11/ PY - 2016/06/26/received PY - 2016/10/04/accepted PY - 2016/10/13/pubmed PY - 2017/5/13/medline PY - 2016/10/13/entrez KW - CLE-test sums score KW - Continuous laryngoscopy exercise test (CLE) KW - Endoscopy supraglottoplasty (ES) KW - Exercise induced laryngeal obstruction (EILO) KW - Laryngeal control therapy (LCT) SP - 1781 EP - 1789 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 - 274 IS - 4 N2 - Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used. Primary searching found 469 records, 308 were excluded following screening of titles and citation. 100 were duplicates, a further 47 studies were excluded after applying inclusion and exclusion criteria. Two studies were identified following cross-referencing. A total of 15 studies were included. The last search date was 6/06/15. Average prevalence in the general adolescent population and athletes was 7.1 and 35.2 %, respectively. Dyspnoea was reported in 96.5, 99 and 100 % of three EILO patient cohorts. Two studies (n = 107) reported continuous laryngoscopy during exercise (CLE) testing could differentiate between patients and controls. In two studies (n = 33) the visual analogue scale (VAS) showed a beneficial effect of endoscopic supraglottoplasty (ES). Thirty-eight out of 43 patients who received two or more laryngeal control therapy sessions (LCT) had improvement or resolution of EILO symptoms. Exercise induced dyspnoea is the most common EILO symptom. EILO has a high occurrence in adolescents and athletes. The CLE test is the current gold standard for EILO diagnostics. Management of EILO includes both surgical and non-surgical interventions. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/27730324/Exercise_induced_laryngeal_obstruction:_a_review_of_diagnosis_and_management_ L2 - https://dx.doi.org/10.1007/s00405-016-4338-1 DB - PRIME DP - Unbound Medicine ER -