Fiberoptic videolaryngoscopy during bicycle ergometry: A diagnostic tool for exercise‐induced vocal cord dysfunction

Tervonen, Hanna; Niskanen, Minna; Sovijärvi, Anssi; Hakulinen, Auli S.; Vilkman, Erkki; Aaltonen, Leena‐Maija

doi:10.1002/lary.20558

Cited by 63 publications

(67 citation statements)

References 13 publications

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“…The presumed primary source of the increased resistance is within the laryngeal airway (because none of the athletes had a diagnosis of lower airway disease), which is detectable by the APD . These results are congruent with reports from direct observation of changes in glottal area during exercise among athletes with PVFMD (Beaty et al, 1999;Heinle et al, 2003;Røksund et al, 2009;Tervonen et al, 2009).…”

Section: Discussionsupporting

confidence: 92%

“…As mentioned in the introduction, exercise-induced laryngomalacia is considered one cause of dyspnea (Christopher & Morris, 2010;Dion, Eller, & Thomas, 2012;Heinle et al, 2003;Richter, Rutter, deAlarcon, Orvidas, & Thompson, 2008;Røksund et al, 2009;Tervonen et al, 2009). To examine the present data for laryngomalacia, the primary investigator retrospectively reviewed laryngoscopic examinations of the athletes with PVFMD after the exercise challenge to determine whether symptoms were related to prolapsed laryngeal and supralaryngeal structures.…”

Section: Discussionmentioning

confidence: 99%

“…To confirm PVFMD, an examiner typically views the larynx using laryngoscopy once the symptomatic behavior is triggered (Balkissoon & Kenn;Christopher et al, 1983;Røksund et al, 2009;Tervonen et al, 2009). In previous publications, we demonstrated construct validity and test-retest reliability (Gallena, Solomon, Johnson, Vossoughi, & Tian, 2014) of a less intrusive method to infer laryngeal airway patency.…”

mentioning

confidence: 83%

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The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

Gallena

Solomon

Johnson

et al. 2015

Am J Speech Lang Pathol

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a,e Purpose: An investigational, portable instrument was used to assess inspiratory (R i ) and expiratory (R e ) resistances during resting tidal breathing (RTB), postexercise breathing (PEB), and recovery breathing (RB) in athletes with and without paradoxical vocal fold motion disorder (PVFMD). Method: Prospective, controlled, repeated measures withinsubject and between-groups design. Twenty-four teenage female athletes, 12 with and 12 without PVFMD, breathed into the Airflow Perturbation Device for baseline measures of respiratory resistance and for two successive 1-min trials after treadmill running for up to 12 min. Exercise duration and dyspnea ratings were collected and compared across groups. Results: Athletes with PVFMD had lower than control R i and R e values during RTB that significantly increased at PEB and decreased during RB. Control athletes' R e decreased significantly from RTB to PEB but not from PEB to RB, whereas R i did not change from RTB to PEB but decreased from PEB to RB. Athletes without PVFMD ran longer, providing lower dyspnea ratings. Conclusion: Immediately following exercise, athletes with PVFMD experienced increased respiratory resistance that affected their exercise performance. The difference in resting respiratory resistances between groups is intriguing and could point to anatomical differences or neural adaptation in teenagers with PVFMD. The Airflow Perturbation Device appears to be a clinically feasible tool that can provide insight into PVFMD and objective data for tracking treatment progress.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 83%

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The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

Gallena

Solomon

Johnson

et al. 2015

Am J Speech Lang Pathol

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“…However, in the past decade, several authors have advocated the use of continuous laryngoscopy during exercise as the preferred means to identify ILO [30][31][32]. This is a procedure which features an exercise challenge with a flexible Inducible laryngeal obstruction during exercise 17 laryngoscope mounted to a patient for the duration of the challenge.…”

Section: Diagnostic Evaluationmentioning

confidence: 98%

Inducible laryngeal obstruction during exercise: moving beyond vocal cords with new insights

Olin

Clary²,

Deardorff

et al. 2015

The Physician and Sportsmedicine

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Exercise as an important part of life for the health and wellness of children and adults. Inducible laryngeal obstruction (ILO) is a consensus term used to describe a group of disorders previously called vocal cord dysfunction, paradoxical vocal fold motion, and numerous other terms. Exercise-ILO can impair one's ability to exercise, can be confused with asthma, leading to unnecessary prescription of asthma controller and rescue medication, and results in increased healthcare resource utilization including (rarely) emergency care. It is characterized by episodic shortness of breath and noisy breathing that generally occurs at high work rates. The present diagnostic gold standard for all types of ILO is laryngoscopic visualization of inappropriate glottic or supraglottic movement resulting in airway narrowing during a spontaneous event or provocation challenge. A number of different behavioral techniques, including speech therapy, biofeedback, and cognitive-behavioral psychotherapy, may be appropriate to treat individual patients. A consensus nomenclature, which will allow for better characterization of patients, coupled with new diagnostic techniques, may further define the epidemiology and etiology of ILO as well as enable objective evaluation of therapeutic modalities.

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“…38 However, the gold standard diagnostic test for VCD is video laryngoscopy. 57 This is typically performed during or immediately following an exercise test meant to provoke VCD. 57 Unfortunately, video laryngoscopy is an invasive procedure in which a video laryngoscope is introduced through the patient’s nose and advanced to their nasopharynx such that the vocal cords can be visualized.…”

Section: Sonographic Evaluation For Vocal Cord Dysfunctionmentioning

confidence: 99%

Sports Ultrasound

et al. 2016

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Background:Traditionally, ultrasound has been used to evaluate musculoskeletal injuries in athletes; however, ultrasound applications extend well beyond musculoskeletal conditions, many of which are pertinent to athletes.Evidence Acquisition:Articles were identified in PubMed using the search terms ultrasound, echocardiogram, preparticipation physical examination, glycogen, focused assessment with sonography of trauma, optic nerve, and vocal cord dysfunction. No date restrictions were placed on the literature search.Study Design:Clinical review.Level of Evidence:Level 4.Results:Several potential applications of nonmusculoskeletal ultrasound in sports medicine are presented, including extended Focused Assessment with Sonography for Trauma (eFAST), limited echocardiographic screening during preparticipation physical examinations, assessment of muscle glycogen stores, optic nerve sheath diameter measurements in athletes with increased intracranial pressure, and assessment of vocal cord dysfunction in athletes.Conclusion:Ultrasound can potentially be used to assist athletes with monitoring their muscle glycogen stores and the diagnosis of multiple nonmusculoskeletal conditions within sports medicine.

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Fiberoptic videolaryngoscopy during bicycle ergometry: A diagnostic tool for exercise‐induced vocal cord dysfunction

Cited by 63 publications

References 13 publications

The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

Inducible laryngeal obstruction during exercise: moving beyond vocal cords with new insights

Sports Ultrasound

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