title: Inducible laryngeal obstruction during exercise: moving beyond vocal cords with new insights.
abstract: Exercise as an important part of life for the health and wellness of children and adults. Inducible laryngeal obstruction (ILO) is a consensus term used to describe a group of disorders previously called vocal cord dysfunction, paradoxical vocal fold motion, and numerous other terms. Exercise-ILO can impair one's ability to exercise, can be confused with asthma, leading to unnecessary prescription of asthma controller and rescue medication, and results in increased healthcare resource utilization including (rarely) emergency care. It is characterized by episodic shortness of breath and noisy breathing that generally occurs at high work rates. The present diagnostic gold standard for all types of ILO is laryngoscopic visualization of inappropriate glottic or supraglottic movement resulting in airway narrowing during a spontaneous event or provocation challenge. A number of different behavioral techniques, including speech therapy, biofeedback, and cognitive-behavioral psychotherapy, may be appropriate to treat individual patients. A consensus nomenclature, which will allow for better characterization of patients, coupled with new diagnostic techniques, may further define the epidemiology and etiology of ILO as well as enable objective evaluation of therapeutic modalities.
authors: Department of Pediatrics, National Jewish Health, Pediatric Exercise Tolerance Center , Denver, CO , USA.
authors: James Tod
authors: JT
authors: Olin
authors: Matthew S
authors: MS
authors: Clary
authors: Emily H
authors: EH
authors: Deardorff
authors: Kristina
authors: K
authors: Johnston
authors: Michael J
authors: MJ
authors: Morris
authors: Mofiyinfolu
authors: M
authors: Sokoya
authors: Herman
authors: H
authors: Staudenmayer
authors: Kent L
authors: KL
authors: Christopher
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002648:Child; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D007830:Larynx / Q000473:pathology*; D064706:Vocal Cord Dysfunction / Q000175:diagnosis; D014827:Vocal Cords
keywords: Continuous laryngoscopy during exercise; exercise-induced laryngeal obstruction; exertional dyspnea; inducible laryngeal obstruction; paradoxical vocal fold motion; vocal cord dysfunction