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[Inducible laryngeal obstruction vs. bronchial asthma]
S Miller1, M Jungheim1, C Schwemmle1
1Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Hannover.
Laryngo- Rhino- Otologie
|July 5, 2014
Summary
Inducible laryngeal obstruction (ILO) can mimic asthma symptoms. Spiroergometry effectively diagnoses exercise-induced laryngeal obstruction (EILO) by showing characteristic changes during exertion.
Area of Science:
- Respiratory Medicine
- Pulmonology
- Laryngology
Context:
- Inducible laryngeal obstruction (ILO) presents as paroxysmal dyspnea, often misdiagnosed as bronchial asthma.
- Exercise-induced laryngeal obstruction (EILO) is a specific type of ILO requiring accurate differentiation from asthma.
Purpose:
- To present three cases of EILO.
- To demonstrate the diagnostic utility of spiroergometry in identifying EILO.
- To differentiate EILO from bronchial asthma.
Summary:
- Spiroergometry reproducibly provoked EILO symptoms in three patients, characterized by stridor onset approximately 1.5-2 minutes after exceeding the anaerobe threshold.
- During EILO provocation, spiroergometry revealed a decline or plateau in carbon dioxide and oxygen intake.
- Laryngoscopy showed inspiratory vocal cord adduction and supraglottic collapse, confirming EILO.
Impact:
- This study establishes spiroergometry as a distinct diagnostic tool for EILO.
- Endoscopy post-peak exhaustion is confirmed as a practical method for EILO identification.
- Improved diagnostic accuracy for EILO can prevent misdiagnosis and ensure appropriate patient management.
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