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Exercise induced dyspnea in the young. Larynx as the bottleneck of the airways
- Source :
- Respiratory medicine. 103(12)
- Publication Year :
- 2009
-
Abstract
- Summary Background Exercise induced asthma may symptomatically be difficult to differentiate from exercise related obstruction in the upper airways, sometimes leading to diagnostic confusion and inappropriate treatment. Larynx accounts for a significant fraction of total airway resistance, but its role as a limiting factor for airflow during exercise has been hampered by lack of diagnostic tools. We aimed to study laryngeal function in exercising humans by transnasal laryngoscopy. Methods Continuous video recording of the larynx was performed in parallel with continuous film recording of the upper part of the body and recording of breath sounds in subjects running to respiratory distress or exhaustion on a treadmill. Results A successful examination was obtained in 20 asymptomatic volunteers and 151 (91%) of 166 young patients with a history of inspiratory distress or stridor during exercise. At rest, six patients had abnormal laryngeal findings. During exercise, a moderate or severe adduction of laryngeal structures was observed in parallel with increasing inspiratory distress in 113 (75%) patients. In 109 of these, adduction started within supraglottic structures, followed by adduction of the vocal cords in 88. In four patients, laryngeal adduction started in the vocal cords, involving supraglottic structures secondarily in three. Conclusion Larynx can safely be studied throughout a maximum intensity exercise treadmill test. A characteristic laryngeal response pattern to exercise was visualised in a large proportion of patients with suspected upper airway obstruction. Laryngoscopy during ongoing symptoms is recommended for proper assessment of these patients.
- Subjects :
- Exercise induced laryngomalacia
Pulmonary and Respiratory Medicine
Larynx
Male
Adolescent
Vocal cord dysfunction
Stridor
Laryngoscopy
Physical exercise
Exercise induced asthma
Running
Young Adult
medicine
Laryngomalacia
Humans
Respiratory Sounds
medicine.diagnostic_test
Respiratory distress
business.industry
Airway obstruction
medicine.disease
medicine.anatomical_structure
Dyspnea
Anesthesia
Exercise Test
Female
Exercise induced inspiratory stridor
medicine.symptom
business
Subjects
Details
- ISSN :
- 15323064
- Volume :
- 103
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Respiratory medicine
- Accession number :
- edsair.doi.dedup.....efdaa2f78e25bcd1896141f67576bd91