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Ann Otol Rhinol Laryngol. 2018 Nov;127(11):754-762. doi: 10.1177/0003489418796524. Epub 2018 Sep 6.

The Study of Laryngoscopic and Autonomic Patterns in Exercise-Induced Laryngeal Obstruction.

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1 Department of Otolaryngology, NYU Langone Medical Center, Voice Center, New York, New York, USA.
2 Massachusetts Eye and Ear, Pediatric Airway, Voice, and Swallowing Center, Division of Pediatric Otolaryngology, Boston, Massachusetts, USA.
3 School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
4 Massachusetts Eye and Ear, Voice and Speech Laboratory, Boston, Massachusetts, USA.
5 Department of Communication Sciences and Disorders, University of Delaware, Newark, Deleware, USA.



(1) Identify laryngeal patterns axiomatic to exercise-induced laryngeal obstruction (EILO) and (2) investigate the role of autonomic function in EILO.


Twenty-seven athletic adolescents (13 EILO, 14 control) underwent laryngoscopy at rest and exercise. Glottal configurations, supraglottic dynamics, systolic blood pressure responses, and heart rate recovery were compared between conditions and groups.


Inspiratory glottal angles were smaller in the EILO group than the control group with exercise. However, group differences were not statistically significant ( P > .05), likely due to high variability of laryngeal responses in the EILO group. Expiratory glottal patterns showed statistically greater abductory responses to exercise in the control group ( P = .001) but not the EILO group ( P > .05). Arytenoid prolapse occurred variably in both groups. Systolic blood pressure responses to exercise were higher in the control group, and heart rate recovery was faster in the EILO group. However, no significant differences were seen between the 2 groups on either autonomic parameter ( P > .05).


"Paradoxical" inspiratory and blunted expiratory vocal fold pattern responses to exercise best characterize EILO. Group differences were only seen with exercise challenge, thus highlighting the utility of provocation and control groups to identify EILO.


airway disorders; endoscopy; exercise; laryngeal physiology; laryngology; miscellaneous; otolaryngology; vocal cord dysfunction

[Indexed for MEDLINE]

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