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Severe Exercise-Induced Laryngeal Obstruction Treated With Supraglottoplasty
Astrid Sandnes1,2, Magnus Hilland3, Maria Vollsæter2,4,5
1Department of Internal Medicine, Innlandet Hospital Trust, Gjøvik, Norway.
Frontiers in Surgery
|August 17, 2019
Summary
Laser supraglottoplasty effectively treats severe exercise-induced laryngeal obstruction (EILO) in adolescents, significantly reducing symptoms and airway obstruction. The procedure demonstrated a high success rate with minimal complications in selected patients.
Area of Science:
- Otolaryngology
- Pediatric Pulmonology
- Surgical Innovation
Background:
- Exercise-induced laryngeal obstruction (EILO) is common in adolescents, often misdiagnosed as asthma.
- Symptoms arise from supraglottic structure collapse, necessitating surgical intervention in severe cases.
- Supraglottoplasty is a surgical option for highly selected patients with severe EILO.
Purpose of the Study:
- To evaluate the efficacy and safety of laser supraglottoplasty for severe supraglottic EILO.
- To assess symptom improvement and objective measures of laryngeal obstruction post-surgery.
Main Methods:
- Retrospective review of patients with severe supraglottic EILO undergoing laser supraglottoplasty (2013-2015).
- Surgical technique involved laser incision and mucosal removal in the aryepiglottic folds under general anesthesia.
- Outcomes measured via self-reported symptoms and continuous laryngoscopy exercise (CLE) test scores pre- and post-operatively.
Main Results:
- 84% of patients reported reduced symptoms post-surgery.
- All patients showed improved CLE-test scores, with 36% having no obstruction.
- Improvements observed at both supraglottic and glottic levels; 47% improved at the glottic level.
- Two patients experienced minor complications: vocal fold paresis and scarring.
Conclusions:
- Laser supraglottoplasty is an effective treatment for severe supraglottic EILO in adolescents.
- The procedure significantly improves patient-reported symptoms and objective laryngeal obstruction.
- Supraglottoplasty is a safe option for carefully selected EILO patients.
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