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Diagnostic work-up of exercise-induced laryngeal obstruction.
Giraud, Ludovic; Destors, Marie; Clin, Rita; Fabre, Christol; Doutreleau, Stéphane; Atallah, Ihab.
Afiliación
  • Giraud L; Otolaryngology-Head and Neck Surgery Department, Clinique Universitaire d'ORL et Chirurgie Cervico-Faciale, CHU Grenoble Alpes, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble Cedex 09, France.
  • Destors M; Faculté́ de Médecine, Université́ Grenoble Alpes, Domaine de la Merci, BP 170, 38042, Grenoble Cedex 9, France.
  • Clin R; Clinique de Physiologie Sommeil et Exercice, CHU Grenoble Alpes, BP 217, 38043, Grenoble Cedex 09, France.
  • Fabre C; Clinique de Physiologie Sommeil et Exercice, CHU Grenoble Alpes, BP 217, 38043, Grenoble Cedex 09, France.
  • Doutreleau S; Inserm 1042, Laboratoire HP2, Université Grenoble-Alpes, 38000, Grenoble, France.
  • Atallah I; Pôle Thorax et Vaisseaux, Clinique de Physiologie Sommeil et Exercice, CHU de Grenoble-Alpes, 38000, Grenobl, France.
Eur Arch Otorhinolaryngol ; 280(3): 1273-1281, 2023 Mar.
Article en En | MEDLINE | ID: mdl-36136148
PURPOSE: Exercise-induced laryngeal obstruction (EILO) is suspected when dyspnea associated with upper airway symptoms is triggered by exercise. This condition affects mainly adolescent athletes. Visualization of the obstruction, while the patient is experiencing the symptoms during continuous laryngoscopy during exercise (CLE-test) is the gold standard for diagnosing EILO. Our study aims to evaluate the prevalence of EILO in a population presenting exercise-induced inspiratory symptoms (EIIS) or uncontrolled asthma with exertional symptoms. The second objective was to evaluate the diagnostic strength of laryngology consultation (LC) and pulmonary function tests (PFTs). METHODS: All patients referred to our center for EIIS or uncontrolled asthma with exertional symptoms were included. EILO diagnosis was made if Maat score was > 2 for patients with CLE-test or if there were inspiratory anomalies on PFTs and LC. The sensitivity and specificity of LC and PFTs as diagnostic tools were calculated considering CLE-test as the gold standard. RESULTS: Sixty two patients were referred to our center for EIIS or uncontrolled asthma with exertional symptoms. EILO was diagnosed in 28 patients (56%) with associated asthma in 9 patients (18%). The sensibility and specificity of LC for supraglottic anomalies were 75% and 60%, respectively. The sensibility and specificity of PFTs were 61% and 89%, respectively. CONCLUSIONS: There was a high prevalence of EILO among patients with EIIS and uncontrolled asthma. Some clinical characteristics might guide the diagnosis. Nevertheless, CLE-test remained the gold standard for EILO diagnosis and identification of the dysfunctional upper airway site to provide specific management.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Asma Inducida por Ejercicio / Enfermedades de la Laringe / Obstrucción de las Vías Aéreas / Laringe Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Asma Inducida por Ejercicio / Enfermedades de la Laringe / Obstrucción de las Vías Aéreas / Laringe Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Alemania