title: Exercise-induced laryngeal obstruction: natural history and effect of surgical treatment.
abstract: The current follow-up study concerning the supraglottic type of exercise-induced laryngeal obstruction (EILO) was performed to reveal the natural history of supraglottic EILO and compare the symptoms, as well as the laryngeal function in conservatively versus surgically treated patients. A questionnaire-based survey was conducted 2-5 years after EILO was diagnosed by a continuous laryngoscopy exercise (CLE) test in 94 patients with a predominantly supraglottic obstruction. Seventy-one patients had been treated conservatively and 23 with laser supraglottoplasty. The questionnaire response rate was 70 and 100% in conservatively treated (CT) and surgically treated (ST) patients, respectively. A second CLE test was performed in 14 CT and 19 ST patients. A visual analogue scale on symptom severity indicated improvements in both the groups, i.e. mean values (± standard deviations) declined from 73 (20) to 53 (26) (P < 0.001) in the CT group and from 87 (26) to 25 (27) (P < 0.001) in the ST group. At follow-up, ST patients reported lower scores regarding current level of complaints, and higher ability to perform exercise, as well as to push themselves physically, all compared to CT patients (P < 0.001). CLE scores were normalized in 3 of 14 (21%) CT and 16 of 19 (84%) ST patients (Z = -3.6; P < 0.001). In conclusion, symptoms of EILO diagnosed in adolescents generally decreased during 2-5 years follow-up period but even more after the surgical treatment. Patients with supraglottic EILO may benefit from supraglottoplasty both as to laryngeal function and symptom relief.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Haukeland University Hospital, 5021 Bergen, Norway. rcmaat@yahoo.com
authors.forename: Robert Christiaan
authors.initials: RC
authors.lastname: Maat
authors.forename: Magnus
authors.initials: M
authors.lastname: Hilland
authors.forename: Ola Drange
authors.initials: OD
authors.lastname: Røksund
authors.forename: Thomas
authors.initials: T
authors.lastname: Halvorsen
authors.forename: Jan
authors.initials: J
authors.lastname: Olofsson
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Aarstad
authors.forename: John-Helge
authors.initials: JH
authors.lastname: Heimdal
mesh_terms: D000293:Adolescent; D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D007829:Laryngostenosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome