open access

Vol 88, No 2 (2020)
ORIGINAL PAPERS
Published online: 2020-04-30
Submitted: 2019-12-23
Accepted: 2020-02-13
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Prevalence of inducible laryngeal obstruction among patients diagnosed as bronchial asthma

Heba Wagih Abdelwahab, Amal Aboelnass, Amer Ayman, Amany Ragab Elsaid, Nesrine Saad Farrag, Ahmed M Hamad
DOI: 10.5603/ARM.2020.0087
·
Pubmed: 32383464
·
Adv Respir Med 2020;88(2):129-133.

open access

Vol 88, No 2 (2020)
ORIGINAL PAPERS
Published online: 2020-04-30
Submitted: 2019-12-23
Accepted: 2020-02-13

Abstract

Introduction: Inducible laryngeal obstruction (ILO) is an important cause of a variety of respiratory symptoms and can mimic bronchial asthma (BA). This study was planned to measure the prevalence of ILO among patients diagnosed with BA and to detect its effect on BA control and severity. Material and methods: Patients aged 18 years or older who were previously diagnosed with BA were enrolled. Laryngeal obstruction was induced using the patient’s specific trigger (e.g. exercise). Visualization of vocal folds was accomplished using  a 70-degree rigid laryngoscope (Karl Storz). A visual grade score was utilized to determine the severity of laryngeal obstruction. Results: Results showed that 38.3% (n = 46) of the patients had ILO with the majority being classified as grade 2 (80.4%)  (n = 37). The most common subtype was glottic ILO (63%). Bronchial asthma duration, level of control, and severity were not associated with ILO (P values: 0.2, 0.3 and 0.8 respectively). Conclusion: Asthma and ILO commonly co-exist. An accurate classification of patients is very important and must be considered in order to determine whether the symptoms are directly related to ILO or whether they are caused by BA. Ceasing inappropriate treatment may be necessary. Objective diagnostic modalities of ILO are essential.

Abstract

Introduction: Inducible laryngeal obstruction (ILO) is an important cause of a variety of respiratory symptoms and can mimic bronchial asthma (BA). This study was planned to measure the prevalence of ILO among patients diagnosed with BA and to detect its effect on BA control and severity. Material and methods: Patients aged 18 years or older who were previously diagnosed with BA were enrolled. Laryngeal obstruction was induced using the patient’s specific trigger (e.g. exercise). Visualization of vocal folds was accomplished using  a 70-degree rigid laryngoscope (Karl Storz). A visual grade score was utilized to determine the severity of laryngeal obstruction. Results: Results showed that 38.3% (n = 46) of the patients had ILO with the majority being classified as grade 2 (80.4%)  (n = 37). The most common subtype was glottic ILO (63%). Bronchial asthma duration, level of control, and severity were not associated with ILO (P values: 0.2, 0.3 and 0.8 respectively). Conclusion: Asthma and ILO commonly co-exist. An accurate classification of patients is very important and must be considered in order to determine whether the symptoms are directly related to ILO or whether they are caused by BA. Ceasing inappropriate treatment may be necessary. Objective diagnostic modalities of ILO are essential.

Get Citation

Keywords

inducible laryngeal obstruction; bronchial asthma; bronchial asthma control and severity

About this article
Title

Prevalence of inducible laryngeal obstruction among patients diagnosed as bronchial asthma

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 2 (2020)

Pages

129-133

Published online

2020-04-30

DOI

10.5603/ARM.2020.0087

Pubmed

32383464

Bibliographic record

Adv Respir Med 2020;88(2):129-133.

Keywords

inducible laryngeal obstruction
bronchial asthma
bronchial asthma control and severity

Authors

Heba Wagih Abdelwahab
Amal Aboelnass
Amer Ayman
Amany Ragab Elsaid
Nesrine Saad Farrag
Ahmed M Hamad

References (7)
  1. Halvorsen T, Walsted ES, Bucca C, et al. Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement. Eur Respir J. 2017; 50(3).
  2. Olin JT, Clary MS, Deardorff EH, et al. Inducible laryngeal obstruction during exercise: moving beyond vocal cords with new insights. Phys Sportsmed. 2015; 43(1): 13–21.
  3. Christensen PM, Heimdal JH, Christopher KL, et al. ERS/ELS/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions. Eur Respir Rev. 2015; 24(137): 445–450.
  4. Fowler SJ, Thurston A, Chesworth B, et al. The VCDQ — a Questionnaire for symptom monitoring in vocal cord dysfunction. Clin Exp Allergy. 2015; 45(9): 1406–1411.
  5. Maat RC, Røksund OD, Halvorsen T, et al. Audiovisual assessment of exercise-induced laryngeal obstruction: reliability and validity of observations. Eur Arch Otorhinolaryngol. 2009; 266(12): 1929–1936.
  6. Halvorsen T, Walsted ES, Bucca C, et al. Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement . Eur Respir J. 2017; 50(3): 1602221.
  7. Lee JW, Tay TR, Paddle P, et al. Diagnosis of concomitant inducible laryngeal obstruction and asthma. Clin Exp Allergy. 2018; 48(12): 1622–1630.

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