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dc.contributor.authorRøksund, Ola Drangeen_US
dc.contributor.authorHeimdal, John-Helgeen_US
dc.contributor.authorOlofsson, Janen_US
dc.contributor.authorMaat, Roberten_US
dc.contributor.authorHalvorsen, Thomasen_US
dc.description.abstractExercise-induced shortness of breath is not uncommon in otherwise healthy young people. Based on the presenting symptoms alone, it is challenging to distinguish exercise-induced asthma (EIA) from exercise-induced obstruction of central airways, sometimes leading to diagnostic errors and inadequate treatment. Central airway obstruction usually presents with exercise-induced inspiratory symptoms (EIIS) during ongoing exercise. EIIS tends to peak towards the end of an exercise session or immediately after its completion, contradicting symptoms of EIA typically peaking 3–15 min after the exercise has stopped. EIIS is usually associated with some form of laryngeal obstruction. Transnasal flexible laryngoscopy performed continuously throughout an incremental exercise test from rest to exhaustion or to intolerable symptoms is usually diagnostic, and also provides information that is important for further handling and treatment. Reflecting the complex anatomy and functional features of the larynx, exercise-induced laryngeal obstruction (EILO) appears to be a heterogeneous condition. Contradicting previous beliefs, recent literature suggests that laryngeal adduction in a majority of cases starts in supraglottic structures and that vocal cord adduction (VCD) most often occurs as a secondary phenomenon. However, EILO is poorly understood and more and better research is needed to unravel causal mechanisms. The evidence base for treatment of EILO is weak. Speech therapy, psychotherapy, biofeedback, muscle training, anticholinergic aerosols have all been applied, as has laser supraglottoplasty. Randomized controlled trials with well-defined and verifiable inclusion and success criteria are required to establish evidence-based treatment schemes.en_US
dc.rightsAttribution CC BYeng
dc.subjectExercise capacityeng
dc.subjectExercise-induced asthmaeng
dc.subjectExercise-induced laryngeal obstructioneng
dc.subjectVocal cord dysfunctioneng
dc.subjectExercise testingeng
dc.subjectRespiratory measurementeng
dc.titleLarynx during exercise: the unexplored bottleneck of the airwaysen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2014 The Authors
dc.source.journalEuropean Archives of Oto-Rhino-Laryngology
dc.subject.nsiVDP::Medical sciences: 700::Clinical medical sciences: 750::Otolaryngology: 755eng
dc.subject.nsiVDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Otorhinolaryngologi: 755nob

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