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. 2017 Apr;274(4):1781-1789.
doi: 10.1007/s00405-016-4338-1. Epub 2016 Oct 11.

Exercise induced laryngeal obstruction: a review of diagnosis and management

Savinda Liyanagedera  1 , Robert McLeod  1 , Hassan A Elhassan  2
Affiliations

Exercise induced laryngeal obstruction: a review of diagnosis and management

Savinda Liyanagedera et al. Eur Arch Otorhinolaryngol. 2017 Apr.

Erratum in

Abstract

Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used. Primary searching found 469 records, 308 were excluded following screening of titles and citation. 100 were duplicates, a further 47 studies were excluded after applying inclusion and exclusion criteria. Two studies were identified following cross-referencing. A total of 15 studies were included. The last search date was 6/06/15. Average prevalence in the general adolescent population and athletes was 7.1 and 35.2 %, respectively. Dyspnoea was reported in 96.5, 99 and 100 % of three EILO patient cohorts. Two studies (n = 107) reported continuous laryngoscopy during exercise (CLE) testing could differentiate between patients and controls. In two studies (n = 33) the visual analogue scale (VAS) showed a beneficial effect of endoscopic supraglottoplasty (ES). Thirty-eight out of 43 patients who received two or more laryngeal control therapy sessions (LCT) had improvement or resolution of EILO symptoms. Exercise induced dyspnoea is the most common EILO symptom. EILO has a high occurrence in adolescents and athletes. The CLE test is the current gold standard for EILO diagnostics. Management of EILO includes both surgical and non-surgical interventions.

Keywords: CLE-test sums score; Continuous laryngoscopy exercise test (CLE); Endoscopy supraglottoplasty (ES); Exercise induced laryngeal obstruction (EILO); Laryngeal control therapy (LCT).

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Conflict of interest statement

Funding

This review received no funding

Conflict of interest

Savinda Liyanagedara, Robert McLeod and Hassan A. Elhassan declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors.

Figures

Fig. 1
Fig. 1
Search strategy to obtain literature is presented. Articles on EILO were included. Exclusion criteria include reviews, thesis, case reports, opinion-based reports, letters, web pages, congress abstracts, Small studies (<5 participants), animal studies and cadaver studies
Fig. 2
Fig. 2
Algorithm for the diagnosis and treatment of EILO
See this image and copyright information in PMC

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