EILO

Q: The typical patient for Exercise-Induced-Laryngeal-Obstruction (EILO) is "a male adolescent competitive athlete who describes the repetitive onset of inspiratory stridor and breathlessness during high-intensity exercise, which may become fatal if not treated promptly."

A) True

B) False

Answer: B

EILO is typically present in young female athletes, although cases have been reported in males and with other high-intensity work.  

This condition is different from Asthma regarding glottic or supraglottic obstruction. Association with high-intensity work is essential for the diagnosis. However, the diagnosis may become challenging if the patient has a simultaneous history of asthma.

As expected, symptoms include dyspnea on exertion, stridor, globus pharyngeus, nonproductive cough, difficulty swallowing saliva, and hoarseness. It is rarely fatal. The obstructive episode is quickly followed by resolution within minutes after cessation of exercise. Patients with repeated episodes need referral and treatment.

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References:

1. Røksund OD, Heimdal JH, Clemm H, et al. Exercise inducible laryngeal obstruction: diagnostics and management. Paediatr Respir Rev 2017; 21:86.

2. Walsted ES, Famokunwa B, Andersen L, et al. Characteristics and impact of exercise-induced laryngeal obstruction: an international perspective. ERJ Open Res 2021; 7.

3. Marcinow AM, Thompson J, Chiang T, et al. Paradoxical vocal fold motion disorder in the elite athlete: experience at a large division I university. Laryngoscope 2014; 124:1425.

4. Halvorsen T, Walsted ES, Bucca C, et al. Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement. Eur Respir J 2017; 50.