Exercise-induced laryngeal obstruction

Exercise-induced laryngeal obstruction (EILO) is a condition characterized by the narrowing of the larynx or voice box during vigorous physical activity, leading to symptoms such as shortness of breath, stridor, and sometimes panic due to the feeling of suffocation. EILO can significantly impact an individual's ability to engage in sports or exercise, affecting their overall quality of life.

Causes and Mechanisms

The exact cause of EILO is not fully understood, but it is believed to involve a combination of factors related to the structure and function of the larynx. During exercise, the demand for air increases, and the larynx is supposed to widen to accommodate this increased airflow. In individuals with EILO, the larynx instead narrows, restricting airflow and leading to symptoms. This abnormal response may be due to dysfunctional neural control or inherent structural abnormalities of the laryngeal cartilages.

Symptoms

Symptoms of EILO typically manifest during or immediately after intense physical activity and may include:

• Difficulty breathing or dyspnea
• High-pitched wheezing or stridor
• Throat tightness
• Coughing
• Voice changes
• Panic or anxiety due to breathing difficulties

Diagnosis

Diagnosis of EILO is primarily based on the patient's history and symptoms, along with the exclusion of other conditions that can cause similar symptoms, such as asthma. A key diagnostic tool is the continuous laryngoscopy during exercise (CLE) test, which involves observing the larynx with a flexible scope during a controlled exercise challenge to directly visualize the behavior of the larynx.

Treatment

Treatment for EILO focuses on managing symptoms and improving airway function during exercise. Strategies may include:

• Breathing exercises designed to promote relaxation and proper laryngeal function
• Speech therapy to teach techniques for controlling the voice and breathing
• In some cases, surgical intervention may be considered to alter the structure of the larynx for better airflow

Prevention

Preventive measures for EILO include:

• Gradual increase in exercise intensity to allow the body to adapt
• Warm-up exercises before engaging in vigorous activity
• Stress management and relaxation techniques to reduce the likelihood of laryngeal dysfunction

See Also

• Asthma
• Vocal cord dysfunction
• Respiratory system
• Physical fitness