Exercise-induced laryngeal obstruction in a competitive swimmer associated with the use of a snorkel

Snorkels are sometimes used by competitive swimmers in inspiratory muscle training and to correct body imbalance. Exercise-induced laryngeal obstruction (EILO) manifests as inspiratory dyspnea during exercise. Patients with EILO are recommended against inspiratory muscle training with high inspiratory resistance. Our patient, a teenage girl, had surgery for supraglottic EILO. A year later, she developed EILO that was apparently associated with using her competitive swimming snorkel. She only had breathing difficulty while using the snorkel. Continuous laryngoscopy showed glottic EILO during exercise tests with the snorkel in place. For swimmers at risk of EILO, using a snorkel requires careful reconsideration.