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Prevalence of inducible laryngeal obstruction among patients diagnosed as bronchial asthma
open access
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.
Keywords
inducible laryngeal obstruction; bronchial asthma; bronchial asthma control and severity
About this articleTitle
Prevalence of inducible laryngeal obstruction among patients diagnosed as bronchial asthma
Journal
Advances in Respiratory Medicine
Issue
Pages
129-133
Published online
2020-04-30
DOI
10.5603/ARM.2020.0087
Pubmed
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)- 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).
- 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.
- 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.
- 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.
- 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.
- 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.
- Lee JW, Tay TR, Paddle P, et al. Diagnosis of concomitant inducible laryngeal obstruction and asthma. Clin Exp Allergy. 2018; 48(12): 1622–1630.