Multidisciplinary management of inducible laryngeal obstruction and breathing pattern disorder

Abstract

We provide an overview of the assessment and management of inducible laryngeal obstruction and breathing pattern disorder. We highlight the multidisciplinary team members involved and their essential roles within a complex breathlessness service. We discuss treatments initiated by physiotherapy and speech and language therapy, the importance of joint working, and discuss the high incidence of comorbidities and the association with other respiratory disorders.Educational aimsInducible laryngeal obstruction and breathing pattern disorder are common causes of breathlessness.Inducible laryngeal obstruction is an inappropriate, transient, reversible narrowing of the laryngeal area that causes breathlessness and laryngeal symptoms.Breathing pattern disorder is an alteration in the normal biomechanical patterns of breathing that results in intermittent or chronic symptoms, which may be respiratory and/or non-respiratory.People with inducible laryngeal obstruction or breathing pattern disorder often have other comorbidities that will also need addressing.Multidisciplinary assessment and treatment is essential for comprehensive workup and holistic care.Timely assessment and diagnosis can prevent unnecessary medication use and hospital admissions and facilitate effective management of the condition using reassurance, advice, education, breathing retraining and vocal exercises.

Dysfunctional Breathing in Children: A Literature Review

“…Since DB symptoms are unspecified, a thorough method for differential diagnosis is crucial in order to verify the implementation of appropriate management [18]. It is certain that comorbidities interact with DB, and they mutually influence each other.…”

“…Their coexistence complicates both diagnosis and therapeutic approaches. The most frequent comorbidities in DB are asthma, gastro-esophageal reflux, nasal diseases, and anxiety/depression [1,18].…”

“…Nasal disease frequently appears as a complicating comorbidity in ILO and BPD, however, treating nasal disease can enhance not only nasal breathing, but likewise alleviate the symptoms associated with ILO and BPD [18,26,27]. In particular, chronic rhinosinusitis exacerbates comorbidity in vocal cord dysfunction (VCD).…”

“…A comprehensive evaluation of DB and its care approaches necessitates a multidisciplinary assessment and treatment [18]. Most patients with DB can be effectively handled through a positive diagnosis, reassurance, disease-specific advice, and breathing retraining [48].…”

The changing face of the modern respiratory clinician

“…As outlined in a forthcoming review from Clements and co-workers, contemporary respiratory pharmacy now encompasses everything from adherence assessment to dose titration, with pharmacists established practitioners across the full gamut of respiratory subspecialties. Similarly, speech and language therapists now take a leading role in the respiratory MDT, in particular working alongside nursing, physiotherapy and medical colleagues in the management of inducible laryngeal obstruction and breathing pattern disorders, as described by L udlow et al [ 2 ].…”