Continuous Laryngoscopy Exercise Test: A Method for Visualizing Laryngeal Dysfunction during Exercise

TLDR

To evaluate the diagnostic feasibility and patient acceptance of a new test for exercise‑induced upper airway flow limitation. The study employed a clinical case‑control design, enrolling 12 asymptomatic controls and 4 symptomatic young females who exercised to exhaustion on a treadmill while continuous ergo‑spirometry and fiberoptic laryngoscopy were recorded by video and sound. The continuous laryngoscopy exercise test was well tolerated, revealed minor aryepiglottic fold motion in controls, and in symptomatic subjects produced inspiratory medial motion of the dorsal aryepiglottic folds, vocal cord adduction, and inspiratory stridor, demonstrating its feasibility for diagnosing laryngeal dysfunction during exercise.

Abstract

Abstract Objectives/Hypothesis: To assess the diagnostic feasibility and patient acceptance of a new developed diagnostic test for exercise induced upper airway flow limitation. Study Design: Clinical case control study including evaluation of contemporary ergo‐spirometry and laryngoscopy continuously performed during exercise. Methods: Twelve nonsymptomatic controls and four young females with documented dyspnea and noisy breathing during exercise were studied. All subjects exercised to exhaustion on a treadmill while attached to a fully equipped ergo‐spirometry unit and a fiberoptic laryngoscope linked to a video camera and a sound recorder. Results: The test situation was well tolerated. Two control subjects had a minor inspiratory synchronous medial motion of the aryepiglottic folds without limitation of laryngeal airflow. In the four symptomatic subjects, exercise induced inspiratory synchronous medial motion of the dorsal part of the aryepiglottic folds as well as vocal cord adduction and inspiratory stridor was demonstrated. Conclusion: The continuous laryngoscopy exercise test was easy to perform, well tolerated, and can be implemented in future diagnostic work‐up programs of laryngeal dysfunction.