Abstract
Background: Exercise induced laryngeal obstruction (EILO) is a prevalent cause of exertional dyspnoea and is associated with increased neural respiratory drive (NRD) and work of breathing. Laser surgery can be effective in reducing supra-glottic obstruction and EILO symptoms, however little is known about the physiological impact of this treatment.
Case description: We described detailed physiological assessments of laser surgery in two patients with severe EILO: a 31-year old male elite cyclist and a 44-year old female recreational athlete. Prior treatment included optimization of co-morbidities and breathing re-training. Both patients underwent a symptom-limited incremental exercise test with simultaneous and synchronised laryngoscopic video, gastric-, oesophageal- and trans-diaphragmatic pressures, diaphragm electromyography and respiratory airflow to delineate how the condition impacted on respiratory mechanics and NRD. These physiological measures were repeated postoperatively within six months.
Results: Surgical intervention led to a marked improvement in peak power, dyspnoea intensity, respiratory mechanics and a reduction of neural respiratory drive (fig. 1).
Conclusion: In this small case series, supraglottopasty for severe EILO was associated with a reduction in NRD and respiratory work and this provides a physiological basis for the clinical outcomes reported from this intervention.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA3358.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018