Infographic. The breathless athlete: EILO

Griffin, Steffan; Walsted, Emil Schwarz; Hull, James H.

doi:10.1136/bjsports-2018-100248

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…We see the high rate of positive CLE tests in this study as a tribute to the referring healthcare providers, having embraced the message needed to differentiate EILO from EIB 33,39 …”

Section: Discussionmentioning

confidence: 80%

“…We see the high rate of positive CLE tests in this study as a tribute to the referring healthcare providers, having embraced the message needed to differentiate EILO from EIB. 33,39 This suggests that skilled trainers and healthcare providers who acknowledge laryngeal obstruction as a relevant diagnostic possibility are able to discriminate between EIB and EILO, providing they carefully observe their athletes during ongoing exercise as they develop their symptoms. In a skilled environment, the real value of the CLE test lies in its indispensable importance for choosing correct strategy for treatment and follow-up.…”

Section: The Value Of Skilled Healthcare Providersmentioning

confidence: 99%

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Conundrums in the breathless athlete; exercise‐induced laryngeal obstruction or asthma?

Hammer

Halvorsen

Vollsæter

et al. 2022

Scandinavian Med Sci Sports

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Purpose Exercise‐induced bronchoconstriction (EIB) and exercise‐induced laryngeal obstruction (EILO) are the two disorders commonly considered when athletes complain of exertional dyspnea. They are highly different but often confused. We aimed to address this diagnostic challenge and its consequences in elite athletes. Methods We included all athletes competing at national or international level, referred to our institution for workup for EILO during 2013–2016. We diagnosed EILO from video‐recorded laryngoscopy performed during maximal cardiopulmonary treadmill exercise (CLE test). Symptoms and previous diagnostic evaluations were obtained from referral letters and chart reviews. Results Exercise‐induced laryngeal obstruction was diagnosed in 73/101 referred athletes, of whom 70/73 had moderate/severe supraglottic obstruction and 3/73 had primarily glottic obstruction with only minor supraglottic involvement. Of the 73 athletes with EILO, we were able to identify objective tests for asthma in 55 participants, of whom 22 had findings supporting asthma. However, 58/73 had used asthma therapy at some time previously, with current use in 28. Only three reported that asthma medication had improved their exercise‐related breathing problems, two of whom with tests confirming asthma. Treatment for EILO improved breathing problems in all but four. Conclusions Objective testing verified EILO in most of the referred athletes. EILO coexisting with asthma was common, and large proportions had used asthma medication; however, few reported effect on exercise‐related breathing problems. Unexplained persistent exertional dyspnea must not lead to indiscriminate escalation of asthma treatment, but instead incite investigation for EILO, either as a co‐morbidity or as a differential diagnosis.

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“…We see the high rate of positive CLE tests in this study as a tribute to the referring healthcare providers, having embraced the message needed to differentiate EILO from EIB 33,39 …”

Section: Discussionmentioning

confidence: 80%

Section: The Value Of Skilled Healthcare Providersmentioning

confidence: 99%

Conundrums in the breathless athlete; exercise‐induced laryngeal obstruction or asthma?

Hammer

Halvorsen

Vollsæter

et al. 2022

Scandinavian Med Sci Sports

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“…It is now recognized that many young athletes with dyspnoea, wheezing and/or coughing may actually be developing respiratory distress due to a transient, excessive closure of the laryngeal inlet (Griffin et al 2019). exercise associated laryngeal obstruction appears to be highly prevalent in adolescents with one study estimating that approximately 5% of all Scandinavian adolescents may suffer with this condition (Johansson et al 2015) and in some series was nearly as common as asthma as a cause of 'unexplained' breathing difficulties in athletes (Nielsen et al 2013).…”

Section: Exercise-induced Laryngeal Obstruction (Eilo)mentioning

confidence: 99%

“…The reason it is important to detect EILO in young swimmers is that it (i) helps provide targeted breathing techniques to optimise breathing control and performance, and (ii) avoids inappropriate use and escalation of asthma therapy. For further information, the reader is encouraged to review the work of Griffin et al (Griffin et al 2019).…”

Section: Onsetmentioning

confidence: 99%

The Respiratory Health of Young Swimmers

Bougault¹,

Hull²

2020

High Performance Youth Swimming

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HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…[38][39][40][41] Although formal behavioral health testing in pediatric patients has not been widely reported, evidence suggests a high prevalence of behavioral health comorbidities in individuals with EILO/ILO. 9,42,43 Patients with EILO have been observed seperately, 3,23,44,45 however, the 2 conditions have frequently been considered as one in research and clinical contexts. 13,18 As such, it is unclear to what extent EILO, ILO, and EILO+ differ one from another.…”

Section: Introductionmentioning

confidence: 99%

Clinical Profiles of Children and Adolescents With Induced Laryngeal Obstruction (ILO) and Exercise Induced Laryngeal Obstruction (EILO)

Fujiki,

Olson-Greb,

Thibeault

2023

Ann Otol Rhinol Laryngol

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Purpose: To compare clinical profiles of pediatric patients with Induced Laryngeal Obstruction (ILO), Exercise Induced Laryngeal Obstruction (EILO), and EILO with non-exertion related secondary triggers (EILO+). Methods: A retrospective observational cohort design was employed. Four-hundred and twenty-three patients <18 years of age were identified from the electronic medical record of a large children’s hospital. All patients underwent evaluations with a laryngologist and speech-language pathologist and were diagnosed with EILO/ILO. Patients were divided into 3 groups based on dyspnea triggers reported in initial evaluations. Groups consisted of patients with EILO (N = 281), ILO (N = 30), and EILO+ (N = 112). Patient demographics, EILO/ILO symptoms, endoscopy findings, medical comorbidities, medical history, and EILO/ILO treatment information were extracted and compared across EILO/ILO subtypes. Results: Patients with EILO experienced higher rates of hyperventilation ( P < .001), sore throat ( P = .023), and chest pain ( P = .003). Patients with ILO were significantly younger in age ( P = .017) and presented with increased rates of nighttime symptoms ( P < .001), globus sensation ( P = .008), self-reported reflux symptoms ( P = .023), and history of gastrointestinal conditions ( P = .034). Patients with EILO+ were more likely to be female ( P = .037) and presented with higher prevalence of anxiety ( P = .003), ADHD ( P = .004), chest tightness ( P = .030), and cough ( P < .001). Conclusions: Patients with EILO, ILO, and EILO+ present with overlapping but unique clinical profiles. A prospective study is warranted to determine the etiology of these differences and clarify how the efficacy of EILO, ILO, and EILO+ treatment can be maximized. Level of Evidence: 4

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Infographic. The breathless athlete: EILO

Cited by 7 publications

References 6 publications

Conundrums in the breathless athlete; exercise‐induced laryngeal obstruction or asthma?

Conundrums in the breathless athlete; exercise‐induced laryngeal obstruction or asthma?

The Respiratory Health of Young Swimmers

Clinical Profiles of Children and Adolescents With Induced Laryngeal Obstruction (ILO) and Exercise Induced Laryngeal Obstruction (EILO)

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