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Logical Approach to the Patient witth Exercise - Induced Laryngal Obstruction (EILO)

Yıl 2019, Cilt: 11 Sayı: 2, 112 - 117, 07.03.2019

Öz

Abstract

Exercise-induced laryngeal obstruction (EILO) describes a condition in which thelarynx closes inappropriately during vigorous exercise to precipitate respiratory symptoms, such as cough, stridor and breathlessness.1  EILO stridor symptoms typically peak towards the close of an exercise session and throughout the first 2–3 minof recovery.  Symptoms are most often limited to the inspiratory phase; rarely to the expiratory phase. The condition is highly prevalent in young athletes and estimatedto affect between 5% and 10% of all adolescents. Research has shown that EILO maycoexist with asthma, and distinguishing between these conditions can be challeng ingand often requires specialist investigation. Visualisation of the larynx during ongoing symptoms is the only objective way of making a complete anatomical diagnosis. Spirometry and other surrogate tests have poor sensitivity and specificity, but might provide useful clinical clues.

Kaynakça

  • Kaynaklar 1.Lands LC. Dyspnea in Children: What is driving it andhow to approach it.. Paediatr Respir Rev. 2017. 2. Johansson H, Norlander K, Hedenström H, Janson C,Nordang L, Nordvall L, Emtner M. Exercise-induceddyspnea is a problem among the general adolescent po-pulation. Respir Med. 2014 Jun;108(6):852-8. doi:10.1016/j.rmed.2014.03.010. Epub 2014 Mar 27. 3. Pasnick SD, Carlos WG, Arunachalam A, Celestin FM,Parsons JP, Hallstrand TS, Anderson SD, Wilson KC,Thomson CC; American Thoracic Society Implementati-on Task Force. Exercise-induced bronchoconstriction.Ann Am Thorac Soc. 2014 Dec;11(10):1651-2. doi:10.1513/AnnalsATS.201409-427OT. 4. Parsons JP, Hallstrand TS, Mastronarde JG, KaminskyDA, Rundell KW, Hull JH, Storms WW, Weiler JM, CheekFM, Wilson KC, Anderson SD; American Thoracic Soci-ety Subcommittee on Exercise-induced Bronchoconstric-tion. An official American Thoracic Society clinical prac-tice guideline: exercise-induced bronchoconstriction. AmJ Respir Crit Care Med. 2013 May 1;187(9):1016-27.doi: 10.1164/rccm.201303-0437ST. 5. Olin JT, Clary MS, Deardorff EH, Johnston K, Morris MJ,Sokoya M, Staudenmayer H, Christopher KL. Induciblelaryngeal obstruction during exercise: moving beyondvocal cords with new insights. Phys Sportsmed. 2015Feb;43(1):13-21. doi: 10.1080/00913847.2015.1007026.Epub 2015 Feb 2. 6. Griffin SA, Walsted ES, Hull JH. Breathless athlete: exer-cise-induced laryngeal obstruction. Br J Sports Med.2018 Sep;52(18):1211-1212. doi: 10.1136/bjsports-2018-099159. Epub 2018 Apr 18. 7. Hilland M, Røksund OD, Sandvik L, Haaland Ø, AarstadHJ, Halvorsen T, Heimdal JH. Congenital laryngomala-cia is related to exercise-induced laryngeal obstructionin adolescence. Arch Dis Child. 2016 May;101(5):443-8.doi: 10.1136/archdischild-2015-308450. 8. Fretzayas A, Moustaki M, Loukou I, Douros K. Differen-tiating vocal cord dysfunction from asthma. J Asthma Al-lergy. 2017 Oct 12;10:277-283. doi:10.2147/JAA. S146007. eCollection 2017. Review.9 9. Weiler JM, Anderson SD, Randolph C, Bonini S, Craig TJ,Pearlman DS, Rundell KW, Silvers WS, Storms WW,Bernstein DI, Blessing-Moore J, Cox L, Khan DA, LangDM, Nicklas RA, Oppenheimer J, Portnoy JM, Schuller DE, Spector SL, Tilles SA, Wallace D, Henderson W,Schwartz L, Kaufman D, Nsouli T, Shieken L, Rosario N;Pathogenesis, prevalence, diagnosis, and management ofexercise-induced bronchoconstriction: a practice para-meter. American Academy of Allergy, Asthma and Immu-nology; American College of Allergy, Asthma and Immu-nology; Joint Council of Allergy, Asthma and Immuno-logy. Ann Allergy Asthma Immunol. 2010 Dec;105(6Suppl):S1-47. doi: 10.1016/j.anai.2010.09.021. 10. Halvorsen T, Walsted ES, Bucca C, et al. Induciblelaryngeal obstruction: an official joint European Respi-ratory Society and European Laryngological Society sta-tement. Eur Respir J 2017; 50. 11. http://www.choosingwisely.org/patient-resources/spiro-metry-for-asthma/ Erişim tarihi 11.03.2019 12. http://www.choosingwisely.org/societies/american-aca-demy-of-allergy-asthma-immunology/ Erişim tarihi11.03.2019 13. Røksund OD, Olin JT, Halvorsen T. Working Towards aCommon Transatlantic Approach for Evaluation of Exer-cise-Induced Laryngeal Obstruction. Immunol AllergyClin North Am 2018; 38:281. 14. Nordang, L., Norlander, K., & Walsted, E. S. (2018).Exercise-Induced Laryngeal Obstruction—An Overview.Immunology and Allergy Clinics of North America, 38(2),271–280. doi:10.1016/j.iac.2018.01.001. 15. Christensen PM, Heimdal JH, Christopher KL, et al.ERS/ELS/ACCP 2013 international consensus conferencenomenclature on inducible laryngeal obstructions. EurRespir Rev 2015; 24:445. 16. https://ginasthma.org/wp-content/uploads/2018/04/wms-GINA-2018-report-V1.3-002.pdf.erişim tarihi:15.03.2019. 17. de Benedictis D, Bush A. Asthma in adolescence: Is thereany news? Pediatr Pulmonol. 2017 Jan;52(1):129-138.doi: 10.1002/ppul.23498. Epub 2016 Jun 6. Review. 18. Bardin PG, Low K, Ruane L, Lau KK.Controversies andconundrums in vocal cord dysfunction. Lancet RespirMed. 2017 Jul;5(7):546-548. doi: 10.1016/S2213-2600(17)30221-7. 19. Johansson H, Norlander K, Berglund L, et al. Prevalenceof exercise-induced bronchoconstriction and exercise-in-duced laryngeal obstruction in a general adolescent po-pulation. Thorax 2015; 70:57. 20. Shembel AC, Hartnick CJ, Bunting G, Ballif C, ShaimanS, de Guzman V, Abbott KV. Perceptual Clinical Featuresin Exercise-Induced Laryngeal Obstruction (EILO): To-ward Improved Diagnostic Approaches. J Voice. 2018Sep 5. pii: S0892-1997(18)30099-7. doi: 10.1016/j.jvoi-ce.2018.05.006. [Epub ahead of print] 21. Liyanagedera S, McLeod R, Elhassan HA. Exercise indu-ced laryngeal obstruction: a review of diagnosis and ma-nagement. Eur Arch Otorhinolaryngol 2017; 274:1781. 22. Hull JH, Walsted ES, Orton CM, Williams P, Ward S, Pa-vitt MJ.Feasibility of portable continuous laryngoscopyduring exercise testing. ERJ Open Res. 2019 Feb 4;5(1).pii: 00219-2018. doi: 10.1183/23120541.00219-2018.eCollection 2019 Feb. 23. Chiang T, Marcinow AM, deSilva BW, et al. Exercise-in-duced paradoxical vocal fold motion disorder: diagnosisand management. Laryngoscope 2013; 123:727. 24. Christensen PM, Maltbæk N, Jørgensen IM, Nielsen KG.Can flow-volume loops be used to diagnose exercise in-duced laryngeal obstructions? A comparison study exa-mining the accuracy and inter-rater agreement of flowvolume loops as a diagnostic tool. Prim Care Respir J2013; 22:306. 25. Walsted ES, Hull JH, Sverrild A, Porsbjerg C, Backer V.Bronchial provocation testing does not detect exercise-in-duced laryngeal obstruction. J Asthma. 2017 Jan2;54(1):77-83. doi: 10.1080/02770903.2016.1195843.Epub 2016 Jun 10. 26. Turmel J, Gagnon S, Bernier M, Boulet LP. Eucapnic vo-luntary hyperpnoea and exercise-induced vocal corddysfunction. BMJ Open Sport Exerc Med 2015;1:e000065. 28. Price OJ, Ansley L, Bikov A, Hull JH. The role of impul-se oscillometry in detecting airway dysfunction in athle-tes. J Asthma 2016; 53:62. 29. Wenzel M. Gasping for a Diagnosis: Pediatric VocalCord Dysfunction. J Pediatr Health Care. 2019Jan;33(1):5-13. doi: 10.1016/j.pedhc.2018.03.002. Epub2018 Apr 13. 30. Giannetti MP Exercise-Induced Anaphylaxis: LiteratureReview and Recent Updates. Curr Allergy Asthma Rep.2018 Oct 26;18(12):72. doi: 10.1007/s11882-018-0830-6. Review. 31. Wauters RH, Banks TA, Lomasney EM. Food-dependentexercise-induced anaphylaxis. BMJ Case Rep.2018:2017–2019. 32. Shaffer M, Litts JK, Nauman E, Haines J. Speech-Lan-guage Pathology as a Primary Treatment for Exercise-In-duced Laryngeal Obstruction. Immunol Allergy ClinNorth Am 2018; 38:293. 33. Olin JT, Westhoff Carlson E. Exercise-Induced LaryngealObstruction and Performance Psychology: Using theMind as a Diagnostic and Therapeutic Target. ImmunolAllergy Clin North Am 2018; 38:303. 34. Shaffer M, Litts JK, Nauman E, Haines J. Speech-Lan-guage Pathology as a Primary Treatment for Exercise-In-duced Laryngeal Obstruction. Immunol Allergy ClinNorth Am. 2018 May;38(2):293-302. doi:10.1016/j.iac.2018.01.003. Epub 2018 Mar 2.

Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım

Yıl 2019, Cilt: 11 Sayı: 2, 112 - 117, 07.03.2019

Öz

Öz

Egzersizle uyarılan laringeal obstrüksiyon, istirahatte belirgin bir patoloji olma-dan, egzersiz sırasında laringeal hava yolunun uygun olmayan şekilde kapanmasını, öksürük, stridor ve nefes darlığı gibi semptomlara neden olmasını tanımlamaktadır. Laringeal obstrüksiyon supraglottik ve/ veya glottik düzeyde olabilir. Semptomlar sıklıkla inspiryumda, nadiren de ekspiryum da görülür. Egzersizle uyarılanlar ingeal obstriksiyon genç atletlerde yüksek prevelansa sahiptir ve tüm adölesanların %5-10’unu etkilediği tahmin edilmektedir. Araştırmalar EULO ile astımın birlikte bulunabileceğini göstermiştir ve bu iki durumun ayrımı zor olmaktadır. Semp-tom varlığında larinksin değerlendirilmesi anatomik tanı için tek objektif yoldur. Spirometri ve diğer testlerin sensitivite ve spesifitesi düşüktür; ancak  yararlı klinik ipuçları sağlayabilir.

Kaynakça

  • Kaynaklar 1.Lands LC. Dyspnea in Children: What is driving it andhow to approach it.. Paediatr Respir Rev. 2017. 2. Johansson H, Norlander K, Hedenström H, Janson C,Nordang L, Nordvall L, Emtner M. Exercise-induceddyspnea is a problem among the general adolescent po-pulation. Respir Med. 2014 Jun;108(6):852-8. doi:10.1016/j.rmed.2014.03.010. Epub 2014 Mar 27. 3. Pasnick SD, Carlos WG, Arunachalam A, Celestin FM,Parsons JP, Hallstrand TS, Anderson SD, Wilson KC,Thomson CC; American Thoracic Society Implementati-on Task Force. Exercise-induced bronchoconstriction.Ann Am Thorac Soc. 2014 Dec;11(10):1651-2. doi:10.1513/AnnalsATS.201409-427OT. 4. Parsons JP, Hallstrand TS, Mastronarde JG, KaminskyDA, Rundell KW, Hull JH, Storms WW, Weiler JM, CheekFM, Wilson KC, Anderson SD; American Thoracic Soci-ety Subcommittee on Exercise-induced Bronchoconstric-tion. An official American Thoracic Society clinical prac-tice guideline: exercise-induced bronchoconstriction. AmJ Respir Crit Care Med. 2013 May 1;187(9):1016-27.doi: 10.1164/rccm.201303-0437ST. 5. Olin JT, Clary MS, Deardorff EH, Johnston K, Morris MJ,Sokoya M, Staudenmayer H, Christopher KL. Induciblelaryngeal obstruction during exercise: moving beyondvocal cords with new insights. Phys Sportsmed. 2015Feb;43(1):13-21. doi: 10.1080/00913847.2015.1007026.Epub 2015 Feb 2. 6. Griffin SA, Walsted ES, Hull JH. Breathless athlete: exer-cise-induced laryngeal obstruction. Br J Sports Med.2018 Sep;52(18):1211-1212. doi: 10.1136/bjsports-2018-099159. Epub 2018 Apr 18. 7. Hilland M, Røksund OD, Sandvik L, Haaland Ø, AarstadHJ, Halvorsen T, Heimdal JH. Congenital laryngomala-cia is related to exercise-induced laryngeal obstructionin adolescence. Arch Dis Child. 2016 May;101(5):443-8.doi: 10.1136/archdischild-2015-308450. 8. Fretzayas A, Moustaki M, Loukou I, Douros K. Differen-tiating vocal cord dysfunction from asthma. J Asthma Al-lergy. 2017 Oct 12;10:277-283. doi:10.2147/JAA. S146007. eCollection 2017. Review.9 9. Weiler JM, Anderson SD, Randolph C, Bonini S, Craig TJ,Pearlman DS, Rundell KW, Silvers WS, Storms WW,Bernstein DI, Blessing-Moore J, Cox L, Khan DA, LangDM, Nicklas RA, Oppenheimer J, Portnoy JM, Schuller DE, Spector SL, Tilles SA, Wallace D, Henderson W,Schwartz L, Kaufman D, Nsouli T, Shieken L, Rosario N;Pathogenesis, prevalence, diagnosis, and management ofexercise-induced bronchoconstriction: a practice para-meter. American Academy of Allergy, Asthma and Immu-nology; American College of Allergy, Asthma and Immu-nology; Joint Council of Allergy, Asthma and Immuno-logy. Ann Allergy Asthma Immunol. 2010 Dec;105(6Suppl):S1-47. doi: 10.1016/j.anai.2010.09.021. 10. Halvorsen T, Walsted ES, Bucca C, et al. Induciblelaryngeal obstruction: an official joint European Respi-ratory Society and European Laryngological Society sta-tement. Eur Respir J 2017; 50. 11. http://www.choosingwisely.org/patient-resources/spiro-metry-for-asthma/ Erişim tarihi 11.03.2019 12. http://www.choosingwisely.org/societies/american-aca-demy-of-allergy-asthma-immunology/ Erişim tarihi11.03.2019 13. Røksund OD, Olin JT, Halvorsen T. Working Towards aCommon Transatlantic Approach for Evaluation of Exer-cise-Induced Laryngeal Obstruction. Immunol AllergyClin North Am 2018; 38:281. 14. Nordang, L., Norlander, K., & Walsted, E. S. (2018).Exercise-Induced Laryngeal Obstruction—An Overview.Immunology and Allergy Clinics of North America, 38(2),271–280. doi:10.1016/j.iac.2018.01.001. 15. Christensen PM, Heimdal JH, Christopher KL, et al.ERS/ELS/ACCP 2013 international consensus conferencenomenclature on inducible laryngeal obstructions. EurRespir Rev 2015; 24:445. 16. https://ginasthma.org/wp-content/uploads/2018/04/wms-GINA-2018-report-V1.3-002.pdf.erişim tarihi:15.03.2019. 17. de Benedictis D, Bush A. Asthma in adolescence: Is thereany news? Pediatr Pulmonol. 2017 Jan;52(1):129-138.doi: 10.1002/ppul.23498. Epub 2016 Jun 6. Review. 18. Bardin PG, Low K, Ruane L, Lau KK.Controversies andconundrums in vocal cord dysfunction. Lancet RespirMed. 2017 Jul;5(7):546-548. doi: 10.1016/S2213-2600(17)30221-7. 19. Johansson H, Norlander K, Berglund L, et al. Prevalenceof exercise-induced bronchoconstriction and exercise-in-duced laryngeal obstruction in a general adolescent po-pulation. Thorax 2015; 70:57. 20. Shembel AC, Hartnick CJ, Bunting G, Ballif C, ShaimanS, de Guzman V, Abbott KV. Perceptual Clinical Featuresin Exercise-Induced Laryngeal Obstruction (EILO): To-ward Improved Diagnostic Approaches. J Voice. 2018Sep 5. pii: S0892-1997(18)30099-7. doi: 10.1016/j.jvoi-ce.2018.05.006. [Epub ahead of print] 21. Liyanagedera S, McLeod R, Elhassan HA. Exercise indu-ced laryngeal obstruction: a review of diagnosis and ma-nagement. Eur Arch Otorhinolaryngol 2017; 274:1781. 22. Hull JH, Walsted ES, Orton CM, Williams P, Ward S, Pa-vitt MJ.Feasibility of portable continuous laryngoscopyduring exercise testing. ERJ Open Res. 2019 Feb 4;5(1).pii: 00219-2018. doi: 10.1183/23120541.00219-2018.eCollection 2019 Feb. 23. Chiang T, Marcinow AM, deSilva BW, et al. Exercise-in-duced paradoxical vocal fold motion disorder: diagnosisand management. Laryngoscope 2013; 123:727. 24. Christensen PM, Maltbæk N, Jørgensen IM, Nielsen KG.Can flow-volume loops be used to diagnose exercise in-duced laryngeal obstructions? A comparison study exa-mining the accuracy and inter-rater agreement of flowvolume loops as a diagnostic tool. Prim Care Respir J2013; 22:306. 25. Walsted ES, Hull JH, Sverrild A, Porsbjerg C, Backer V.Bronchial provocation testing does not detect exercise-in-duced laryngeal obstruction. J Asthma. 2017 Jan2;54(1):77-83. doi: 10.1080/02770903.2016.1195843.Epub 2016 Jun 10. 26. Turmel J, Gagnon S, Bernier M, Boulet LP. Eucapnic vo-luntary hyperpnoea and exercise-induced vocal corddysfunction. BMJ Open Sport Exerc Med 2015;1:e000065. 28. Price OJ, Ansley L, Bikov A, Hull JH. The role of impul-se oscillometry in detecting airway dysfunction in athle-tes. J Asthma 2016; 53:62. 29. Wenzel M. Gasping for a Diagnosis: Pediatric VocalCord Dysfunction. J Pediatr Health Care. 2019Jan;33(1):5-13. doi: 10.1016/j.pedhc.2018.03.002. Epub2018 Apr 13. 30. Giannetti MP Exercise-Induced Anaphylaxis: LiteratureReview and Recent Updates. Curr Allergy Asthma Rep.2018 Oct 26;18(12):72. doi: 10.1007/s11882-018-0830-6. Review. 31. Wauters RH, Banks TA, Lomasney EM. Food-dependentexercise-induced anaphylaxis. BMJ Case Rep.2018:2017–2019. 32. Shaffer M, Litts JK, Nauman E, Haines J. Speech-Lan-guage Pathology as a Primary Treatment for Exercise-In-duced Laryngeal Obstruction. Immunol Allergy ClinNorth Am 2018; 38:293. 33. Olin JT, Westhoff Carlson E. Exercise-Induced LaryngealObstruction and Performance Psychology: Using theMind as a Diagnostic and Therapeutic Target. ImmunolAllergy Clin North Am 2018; 38:303. 34. Shaffer M, Litts JK, Nauman E, Haines J. Speech-Lan-guage Pathology as a Primary Treatment for Exercise-In-duced Laryngeal Obstruction. Immunol Allergy ClinNorth Am. 2018 May;38(2):293-302. doi:10.1016/j.iac.2018.01.003. Epub 2018 Mar 2.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm makale
Yazarlar

Uzm. Dr. Ayşe Süleyman

Yayımlanma Tarihi 7 Mart 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 11 Sayı: 2

Kaynak Göster

APA Süleyman, U. D. A. (2019). Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım. Klinik Tıp Pediatri Dergisi, 11(2), 112-117.
AMA Süleyman UDA. Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım. Pediatri. Mart 2019;11(2):112-117.
Chicago Süleyman, Uzm. Dr. Ayşe. “Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım”. Klinik Tıp Pediatri Dergisi 11, sy. 2 (Mart 2019): 112-17.
EndNote Süleyman UDA (01 Mart 2019) Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım. Klinik Tıp Pediatri Dergisi 11 2 112–117.
IEEE U. D. A. Süleyman, “Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım”, Pediatri, c. 11, sy. 2, ss. 112–117, 2019.
ISNAD Süleyman, Uzm. Dr. Ayşe. “Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım”. Klinik Tıp Pediatri Dergisi 11/2 (Mart 2019), 112-117.
JAMA Süleyman UDA. Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım. Pediatri. 2019;11:112–117.
MLA Süleyman, Uzm. Dr. Ayşe. “Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım”. Klinik Tıp Pediatri Dergisi, c. 11, sy. 2, 2019, ss. 112-7.
Vancouver Süleyman UDA. Egzersizle Uyarılan Laringeal Obstrüksiyon (EULO) Olgusuna Akılcı Yaklaşım. Pediatri. 2019;11(2):112-7.