Perceptual Clinical Features in Exercise-Induced Laryngeal Obstruction (EILO): Toward Improved Diagnostic Approaches

摘要: Abstract Introduction Athletes with exercise-induced laryngeal obstruction (EILO) (previously commonly referred to as paradoxical vocal fold motion disorder, or motion, among other terms) are often misdiagnosed, resulting in prolonged, and at times inappropriate, clinical management. The high prevalence of misdiagnosis is largely due a lack universal consensus key features indicating EILO dearth validated quantitative approaches accurately detect episodic breathing disorders (ELBD) from pathologies. Additionally, mechanisms underlying presentation poorly understood, further confounding identification management the condition. Therefore, objectives this study were twofold. first was identify patient-centered perception symptoms that could distinguish adolescent athletes without condition, baseline (rest) during an exercise challenge (provocation), quantify symptom severities for use preliminary diagnostic benchmarks. second objective investigate merit one proposed mechanism literature—stress reactivity (temperament)—by comparing personality traits EILO. Methods Twelve (12) diagnosed 14 healthy athletic volunteers condition asked rate severity their present using 0–100 continuous visual analog scale. Participants then underwent simultaneous laryngoscopy complete same set ratings experienced rigorous exercise. Finally, participants completed Fear subscale on early temperament questionnaire—revised (EATQ-R) measure self-perceived levels stress reactivity. Results There significant group differences inspiratory expiratory dyspnea (P = 0.01). Symptoms stridor (EILO: P = .01; control: P = .001) throat tightness P = .01, P = .01) statistically different between rest both groups. However, no found these two parameters > .05). Other list previously purported indicative ELBD (e.g. cough, dysphonia) infrequently reported variant. measurements EATQ-R similar Interestingly, Subscale scores groups significantly higher compared typical adolescents U.S. population Discussion suggest severity, particularly when episode, most sensitive parameter individuals those These findings confirm previous literature describing cohorts. also showed more prevalent exercise, rest. level occurred variably across may point less robust indication pathology. similarities imply certain temperaments historically attributed patients instead better reflect competitive young athletes, general. Conclusion Study highlight importance normative comparisons prevent overgeneralization characteristics speak utility improve specificity diagnosis.