Lesson of the month: rowing-induced laryngeal obstruction: a novel cause of exertional dyspnoea: characterised by direct laryngoscopy

Abstract

Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for unexplained dyspnoea in athletes. The gold standard means for diagnosis of EILO is direct laryngoscopy, performed continuously, while an athlete undertakes the specific sport that precipitates their symptoms. This report provides the first descriptions of rowing-associated EILO in two competitive rowers presenting with unexplained dyspnoea and cough. The report describes the methodology and safety of the use of continuous laryngoscopy in the context of maximal rowing ergometry and the use of this technique as a therapeutic tool to provide biofeedback.

Exercise-induced bronchoconstriction in athletes – A qualitative assessment of symptom perception

“…These differences, in the site of breathing discomfort, are consistent with previous literature (17) and may indicate the presence of upper airway closure precipitating dyspnoea and more specifically may indicate the presence of exercise-induced laryngeal obstruction (EILO); a mimic of asthma caused by closure of the laryngeal inlet, which does not respond to asthma medication (18)(19)(20)(21).…”

Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement

“…Where exercise is an inducer, laboratory provocation studies attempt to simulate the real-life (i.e. in the field) scenario, but most commonly employ an indoor treadmill [11,17,18], stationary bicycle [19] or, very occasionally, other exercise modalities [20].…”

Not all wheeze is asthma: time for patients toexercisetheir rights

“…It has now been used in a variety of sport-specific settings12 and appears to be well tolerated in very young individuals8; yet the lack of a robust ‘dynamic’ system for scoring laryngeal closure, with proven reproducibility, remains an important shortfall.…”