Breathing pattern disorder is prevalent in patients with subjective symptoms of inducible laryngeal obstruction

Abstract

Introduction: Inducible laryngeal obstruction (ILO) describes paradoxical glottic closure causing throat tightness and dyspnea, and can be diagnosed with continuous laryngoscopy during provocation (CLP). Anecdotally, it is reported that ILO is often associated with development of a breathing pattern disorder (BPD), however this has not been characterised objectively. The aim of this work was to assess BPD in patients referred for CLP. Methodology: Patients with clinical features of irritant-induced ILO were referred from our upper airway clinic for CLP (2018-19). Breathing pattern was assessed using the Brompton Breathing Pattern Assessment Tool (BPAT) at rest and immediately following provocation laryngoscopy with a score of ≥4 taken as indicative of BPD. Results: Thirty-four patients (n=23 female =68%), aged 18-75, underwent CLP, with successful reproduction of their symptoms. The median BPAT score pre-CLP was 3 (range 1-8), increasing to 8 post-CLP (range 2-14, p Conclusion: Breathing pattern irregularities are highly prevalent following laryngoscopic provocation for suspected ILO. These irregularities may be responsible for sensations of tightness and dyspnea that mimic ILO. Targeted intervention for BPD is likely to be an important component in ILO therapy.