PT - JOURNAL ARTICLE AU - Hege Clemm AU - Magnus Hilland AU - Thomas Halvorsen AU - John-Helge Heimdal AU - Ola Røksund TI - Heterogeneity of findings in exercise induced inspiratory stridor (EIIS) DP - 2013 Sep 01 TA - European Respiratory Journal PG - P2528 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/P2528.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/P2528.full SO - Eur Respir J2013 Sep 01; 42 AB - Introduction EIIS has been attributed to inappropriate adduction of the vocal cords (VCD), often without laryngoscopic verification. Some researchers have argued that VCD may be diagnosed from a medical history or symptoms alone, and that laryngoscopy is difficult and unnecessary. This strongly contradicts our experience, with EIIS being associated with a broad spectrum of abnormalities in more than 500 patients tested since 1998, without adverse events.Aim To demonstrate the heterogeneity of findings from continuous laryngoscopy performed during maximal exercise (CLE-test) during 2012 at our institution.Method Patients presenting with EIIS at our institution during the past 15 years have been offered diagnostic examination with the CLE-test, according to our published method; in 2012 performed in 64 new referrals.Results Sixty-three successful tests were performed (72% female; age range 7-62 years of whom 65% range 13-18). Despite similar symptoms, laryngeal findings varied widely. Inappropriate movements of supraglottic structures were the primary obstructing event in 60%, severely impeding the laryngeal inlet in 10% with corresponding severe respiratory distress. In 36% epiglottic abnormalities were observed, seemingly disturbing airflow. Secondary adduction of vocal folds was observed in a large proportion, while primary vocal fold adduction was rare (9%). Extra-laryngeal abnormalities were suspected in seven (11%).Conclusion EIIS has different origins. Adduction of supraglottic structures and not the vocal folds was the inciting event in a majority. EIIS should not be linked to VCD without laryngoscopic verification, which is a safe procedure revealing findings of therapeutic consequences.