Masqueraders of exercise-induced vocal cord dysfunction

Tilles, Stephen A.; Inglis, Andrew F.

doi:10.1016/j.jaci.2009.03.026

Cited by 18 publications

(8 citation statements)

References 7 publications

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“…We found two athletes with anatomical abnormalities. This agrees with a previous report of five cases with anatomical abnormalities referred to a VCD clinic 18. Among this group, two adolescents had fixed positioning of the arytenoid cartilages with post‐exercise laryngomalacia.…”

Section: Discussionsupporting

confidence: 92%

Vocal cord dysfunction in adolescents

Schulze

Weber

Rosewich

et al. 2012

Pediatric Pulmonology

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Section: Discussionsupporting

confidence: 92%

Vocal cord dysfunction in adolescents

Schulze

Weber

Rosewich

et al. 2012

Pediatric Pulmonology

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“…Social stressors are frequently identified and many adolescents are reported to over‐achieve in terms of excellent academic or athletic performances . It often mimics EIB, and may coexist with asthma in up to 50% of cases, thus increasing difficulties in the diagnosis . VCD can be intermittently symptomatic and the characteristic flattening of the inspiratory flow volume curve is very often missing when symptoms are absent.…”

Section: Diagnostic Issuesmentioning

confidence: 99%

Asthma in adolescence: Is there any news?

Benedictis

Bush

2016

Pediatr Pulmonol.

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Asthma is a chronic disease that has a significant impact quality of life, which is particularly important in adolescence. We will discuss aspects of epidemiology, the clinical spectrum, diagnostics, and management of asthma in adolescence. In particular, we will highlight the psychological implications of having asthma during this developmental period. Data published in the past 10 years, since we last reviewed the subject, will be the main focus of this paper. The care of the teenager with asthma should take into account the rapid physical, emotional, cognitive, and social changes that occur during normal adolescence. The diagnostic process may be more difficult since teenagers tend to deny their illness. Thus, both under-diagnosis and under-assessment of asthma severity may lead to under-treatment and potentially avoidable morbidity and even mortality. Conversely, teenagers may be often misdiagnosed as having asthma or their asthma severity may be overestimated leading to inappropriate and sometimes excessive treatment. Educational programs, environmental avoidance measures, proper use of medications along with a skilled approach, and a caring attitude of health providers are all very important for successful management. Pediatr Pulmonol. 2017;52:129-138. © 2016 Wiley Periodicals, Inc.

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“…Three main criteria have been proposed as essential to the diagnosis EILO): (1) Clinical symptoms of EIIS. (2) Confirmatory pulmonary function findings and (3) Laryngeal obstruction, verified laryngoscopically [ 2 , 3 , 15 – 18 ].…”

Section: Diagnosing Eilomentioning

confidence: 99%

“…Visualization of laryngeal structures during exercise has been proposed the “gold standard” for diagnosing EILO [ 2 , 3 , 15 , 17 , 18 , 28 – 30 ]. Christopher showed in a review of 355 articles on VCD that laryngoscopy during ongoing symptoms had not been performed in 38 % of patients [ 15 ].…”

Section: Diagnosing Eilomentioning

confidence: 99%

Larynx during exercise: the unexplored bottleneck of the airways

Røksund

Heimdal

Olofsson

et al. 2014

Eur Arch Otorhinolaryngol

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Exercise-induced shortness of breath is not uncommon in otherwise healthy young people. Based on the presenting symptoms alone, it is challenging to distinguish exercise-induced asthma (EIA) from exercise-induced obstruction of central airways, sometimes leading to diagnostic errors and inadequate treatment. Central airway obstruction usually presents with exercise-induced inspiratory symptoms (EIIS) during ongoing exercise. EIIS tends to peak towards the end of an exercise session or immediately after its completion, contradicting symptoms of EIA typically peaking 3–15 min after the exercise has stopped. EIIS is usually associated with some form of laryngeal obstruction. Transnasal flexible laryngoscopy performed continuously throughout an incremental exercise test from rest to exhaustion or to intolerable symptoms is usually diagnostic, and also provides information that is important for further handling and treatment. Reflecting the complex anatomy and functional features of the larynx, exercise-induced laryngeal obstruction (EILO) appears to be a heterogeneous condition. Contradicting previous beliefs, recent literature suggests that laryngeal adduction in a majority of cases starts in supraglottic structures and that vocal cord adduction (VCD) most often occurs as a secondary phenomenon. However, EILO is poorly understood and more and better research is needed to unravel causal mechanisms. The evidence base for treatment of EILO is weak. Speech therapy, psychotherapy, biofeedback, muscle training, anticholinergic aerosols have all been applied, as has laser supraglottoplasty. Randomized controlled trials with well-defined and verifiable inclusion and success criteria are required to establish evidence-based treatment schemes.Electronic supplementary materialThe online version of this article (doi:10.1007/s00405-014-3159-3) contains supplementary material, which is available to authorized users.

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Masqueraders of exercise-induced vocal cord dysfunction

Cited by 18 publications

References 7 publications

Vocal cord dysfunction in adolescents

Vocal cord dysfunction in adolescents

Asthma in adolescence: Is there any news?

Larynx during exercise: the unexplored bottleneck of the airways

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