Abstract
Introduction: Exercise-induced bronchoconstriction (EIB) is a common condition. Exercise-induced vocal cords dysfunction (EIVCD) is a frequent confounder of EIB and is the most common cause of upper airway obstruction during exercise.The diagnosis of EIVCD is not obvious and can be missed as the problem is often intermittent and may only occur during intense exercise. EVH is considered one of the best tests to detect EIB. This pilot study aims to assess if EVH can be helpful in the diagnosis of EIVCD associated or not to EIB in athletes. Methods: A nasolaryngoscopy was done during a 6-minute EVH test by an otorhinolaryngologist (ENT), in 13 female athletes suspected to have EIVCD, aged 21 ± 6 years.Image analysis was conducted by 2 ENT in random order. Results: During the EVH, 3 athletes showed incomplete paradoxical vocal cordsmovement, without inspiratory stridor. However, 12 athletes showed supraglottic movement without inspiratory stridor. In 2 athletes, this supraglottic movement was severe, one showing a marked epiglottis collapse with an almost complete obstruction of the larynx by the arytenoid cartilage mucosa. In three of the 12 athletes with supraglottic movement, severe vibration of the arytenoid cartilage mucosa was also observed. Conclusion: EVH challenge in athletes although it can provide information on various types of laryngeal dysfunction in reproducing laryngeal movement during hyperventilation. Exercise-induced inspiratory stridor may be associated with a paradoxical movement of the vocal cords or to a supraglottic movement of various magnitudes.
- © 2014 ERS