Fiberoptic videolaryngoscopy during bicycle ergometry: a diagnostic tool for exercise-induced vocal cord dysfunction

Area of Science:

• Pulmonology
• Otolaryngology
• Sports Medicine

Background:

• Exercise-induced vocal cord dysfunction (EIVCD) presents diagnostic challenges due to the need to observe symptoms during physical exertion.
• Traditional diagnostic methods often fail to capture the transient nature of EIVCD.

Purpose of the Study:

• To develop and validate a novel diagnostic approach for EIVCD.
• To combine continuous fiberoptic laryngoscopy with bicycle ergometry for improved diagnosis.

Main Methods:

• Thirty patients with suspected EIVCD and 15 healthy controls underwent a graded bicycle ergometry test.
• Continuous fiberoptic laryngoscopy monitored laryngeal dynamics during exercise.
• Vital signs and respiratory function were assessed before and after the test.

Main Results:

• The combined diagnostic method was well-tolerated and successfully induced symptoms in a significant portion of patients.
• Diagnostic signs of EIVCD, including inspiratory stridor and vocal cord adduction, were observed in 36% of referred patients.
• In patients who developed dyspnea during the test, 60% were suspected of having EIVCD.

Conclusions:

• Fiberoptic videolaryngoscopy during bicycle ergometry is a feasible and effective tool for diagnosing EIVCD.
• This method facilitates the observation of characteristic laryngeal changes during exercise-induced dyspnea.
• The combined approach improves the diagnostic yield for EIVCD, particularly when dyspnea is provoked.