Comparison between two assessment methods for exercise-induced laryngeal obstructions.
Exercise-induced laryngeal obstructions (E-ILOs) are important differential diagnoses to exercise-induced asthma and are diagnosed by the continuous laryngoscopy exercise (CLE) test. There are two different methods for evaluating the severity of E-ILOs using recordings from the CLE test; the CLE score and EILOMEA. The aim of this study was to investigate the consistency between these methods. Using their respective method, the developers of each method evaluated 60 laryngoscopic recordings from patients with different subtypes and various levels of severity of E-ILOs. The CLE score evaluates glottic and supraglottic obstructions on a 4-grade scale. EILOMEA uses software to calculate the obstruction severity on continuous scales from a still frame of the larynx during maximal obstruction giving three parameters reflecting glottic and supraglottic obstruction. The means of the EILOMEA measures differed significantly for CLE score 1 vs. 2 and 2 vs. 3, but not for 0 vs. 1 for glottic as well as supraglottic obstructions. The EILOMEA method does not distinguish between CLE score 0 and 1, but otherwise the methods correlate. Since previous studies have suggested that only CLE scores of 2 and 3 reflect a severity of E-ILOs of clinical importance, this lack of the EILOMEA method is not crucial for a correct medical evaluation.
Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Akademiska Sjukhuset, 751 85, Uppsala, Sweden.
Katarina
K
Norlander
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen E, Denmark. p.christensen@dadlnet.dk.
Pernille M
PM
Christensen
Department of Otolaryngology, Röpcke-Zweers Hospital, Jan Weitkamplaan 4 a, Hardenberg, The Netherlands.
Robert C
RC
Maat
Department of Pediatrics, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Thomas
T
Halvorsen
Department of Otolaryngology-Head and Neck Surgery, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
John Helge
JH
Heimdal
Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Akademiska Sjukhuset, 751 85, Uppsala, Sweden.
Staffan
S
Morén
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen E, Denmark.
Niels
N
Rasmussen
Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Akademiska Sjukhuset, 751 85, Uppsala, Sweden.
Leif
L
Nordang
D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology; D001250:Asthma, Exercise-Induced / Q000175:diagnosis; D003937:Diagnosis, Differential; D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000209:etiology; D007828:Laryngoscopy / Q000379:methods*; D008297:Male
CLE score; Continuous laryngoscopy exercise test; E-ILO; EILOMEA; Exercise-induced respiratory difficulties