Exercise Induced Laryngeal Obstruction (EILO) – diagnosis and therapy response

Abstract

<b>Background:</b> Patients are referred to our complex breathless service due to a clinical suspicion of inducible laryngeal obstruction (ILO), exercise induced laryngeal obstruction (EILO) and/or breathing pattern disorder (BPD). Gold standard diagnosis of EILO is continuous laryngoscopy during exercise (CLE). <b>Aim:</b> To investigate the clinical and laryngoscopi characteristics of patients with EILO presenting to a complex breathlessness service and their response to therapeutic interventions. <b>Method:</b> We reviewed data over a twelve-month period of all patients referred to Manchester airways service who had had a pre and post bicycle CLE and completed a course of therapy. <b>Results:</b> Between January and December 2020, 273 patients were referred; 153 patients (56%) were diagnosed with ILO (n=55), BPD (37) or both (61). Of thirteen patients referred with suspected EILO, 10 were confirmed (70% female, median age 34); with the most common presentation as a supra-glottic type (70%). All patients received speech and language therapy (SLT) consisting of traditional methods and the Olin breathing technique, which employs biphasic inspiratory phase. Results are shown in the table: <b>Conclusion:</b> A high proportion of patients with suspected EILO had this confirmed on CLE, and most had a supraglottic closure of their larynx. A high proportion of EILO patients had supraglottic closure of their larynx. Traditional SLT breathing strategies are not always beneficial in EILO and other techniques should be considered.