The impact of a fast-track questionnaire in pediatric paradoxical vocal fold motion disorder (PVFMD)

Harvey, Erin; Peterson, Eileen; Fee, Rachel; Espahbodi, Mana; Beste, David J.; Robey, Thomas

doi:10.1016/j.ijporl.2022.111252

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…64 Thus, patients were diagnosed using laryngoscopy following exertion as is common in clinical practice and research. [64][65][66] Patients with a history of vocal fold paralysis or paresis, tracheal stenosis, subglottic stenosis, tracheomalacia, bronchomalacia, or upper or lower airway surgery were excluded. Patients were separated into 3 cohorts based on the symptoms documented in their initial speech pathology evaluation.…”

Section: Methodsmentioning

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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Section: Methodsmentioning

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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Therapy Outcomes for Teenage Athletes With Exercise-Induced Laryngeal Obstruction

Fujiki,

Olson-Greb,

Braden

et al. 2023

Am J Speech Lang Pathol

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Purpose: This study examined treatment outcomes of speech-language pathology intervention addressing exercise-induced laryngeal obstruction (EILO) symptoms in teenage athletes. Method: A prospective cohort design was utilized; teenagers diagnosed with EILO completed questionnaires during initial EILO evaluations, posttherapy, 3-month posttherapy, and 6-month posttherapy. Questionnaires examined the frequency of breathing problems, the use of the techniques taught in therapy, and the use of inhaler. Patients completed the Pediatric Quality of Life (PedsQL) inventory at all time points. Results: Fifty-nine patients completed baseline questionnaires. Of these, 38 were surveyed posttherapy, 32 at 3-month posttherapy, and 27 at 6-month posttherapy. Patients reported more frequent and complete activity participation immediately posttherapy ( p = .017) as well as reduced inhaler use ( p = .036). Patients also reported a significant reduction in the frequency of breathing problems 6-month posttherapy ( p = .015). Baseline PedsQL physical and psychosocial scores were below normative range and were not impacted by therapy. Baseline physical PedsQL score significantly predicted frequency of breathing difficulty 6-month posttherapy ( p = .04), as better baseline scores were associated with fewer residual symptoms. Conclusions: Therapy with a speech-language pathologist for EILO allowed for more frequent physical activity following therapy completion and decreased dyspnea symptoms 6-month posttherapy. Therapy was associated with a decrease in inhaler use. PedsQL scores indicated mildly poor health-related quality of life even after EILO symptoms improved. Findings support therapy as an effective treatment for EILO in teenage athletes and suggest that dyspnea symptoms may continue to improve following discharge as patients continue using therapy techniques.

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Effects of Exercise-Induced Laryngeal Obstruction in Adolescents: A Qualitative Study

Fujiki,

Johnson,

Fujiki

et al. 2024

Am J Speech Lang Pathol

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Purpose: The purpose of this study was to examine the influence of exercise-induced laryngeal obstruction (EILO) on adolescents. Method: Twenty patients (< 17 years) diagnosed with EILO participated in this study. Patients completed semistructured interviews examining their experience with the health care system, treatment, and the effects of EILO symptoms on quality of life. Interviews were analyzed using a combination of directed and conventional content analyses. Researchers identified seven overarching themes either prior to or during analysis, and 24 subthemes were inductively identified from patient interviews using open, axial, and selective coding. Results: On average, patients went 1.9 years between symptom onset and EILO diagnosis. Patients described symptom onset as frightening and confusing. Even after initially reporting symptoms to a medical provider, patients went an average of 10.5 months before diagnosis. Patients perceived that delays in diagnosis prevented efficient management and allowed symptoms to escalate. Patients reported that EILO detrimentally influenced athletic performance, forcing them to pace themselves or cease participation altogether. Social and academic effects of EILO included missed classes, difficulty in physical education courses, and resentment from teammates if athletic performance declined. Both athletes and nonathletes indicated that EILO elicited feelings of fear, frustration, dread, guilt, and embarrassment. Patients reported that therapy with a speech-language pathologist (SLP) effectively addressed symptoms; however, employing rescue breathing techniques was often more difficult than anticipated. Conclusions: Physical and emotional sequelae associated with EILO may have widespread influence on patient quality of life. Therapy with an SLP reportedly ameliorated EILO symptoms; however, patients indicated that delayed diagnosis allowed negative effects to intensify prior to treatment.

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The impact of a fast-track questionnaire in pediatric paradoxical vocal fold motion disorder (PVFMD)

Cited by 3 publications

References 11 publications

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

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

Therapy Outcomes for Teenage Athletes With Exercise-Induced Laryngeal Obstruction

Effects of Exercise-Induced Laryngeal Obstruction in Adolescents: A Qualitative Study

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