Introduction
Systematic method and results
Search strategy
Review
Clinical presentation
Differential diagnoses
Study | Number | % Dyspnoea during exercise | % Hoarse voice/stridor during exercise | % Cough during exercise | % Dysphagia during exercise | % Open glottic configuration during exercise |
---|---|---|---|---|---|---|
Chiang et al. [8] | 104 | 99 | 43 | 38 | 22 | – |
Olin et al. [9] | 23 | 100 | 56.5 | – | – | 78.3 |
Tilles et al. [6] | 143 | 96.5 | 50 | 9.8 | – | – |
Røksund et al. [1] | 113 | – | 68 | – | – | – |
Overall | 383 | 98 | 54 | 22 | 22 | 78.3 |
CLE testing and scoring
Provocation for CLE
EILOMEA
Study | Number of patients | Number of controls | Diagnostic method | Aims | Methodology |
---|---|---|---|---|---|
Tervonen et al. [10] | 30 (successfully carried out the test 27) | 15 | Fiberoptic videolaryngoscopy during bicycle ergometry | Develop and validate a new diagnostic method for EIVCD by combination of continuous fiberoptic laryngoscopy and bicycle ergometry test | Thirty consecutive patients referred to a laryngologist due to EIVCD suspicion and 15 healthy controls underwent CLE testing using fiberoptic videolaryngoscopy during bicycle ergometry |
Maat et al. [11] | 80 | 20 | CLE | Develop and validate a scoring system for laryngeal obstruction as visualized during the CLE-test | 80 patients and 20 symptom-negative volunteers performed a CLE test. Every participant scored symptom severity during exercise. The scoring system has four sub-scores, each graded from 0 to 3. Two independent laryngologists, blinded to clinical data, did scoring of the video recordings of the larynx twice. Assessment of the inter- and intra-observer agreement proportions for each sub-score through these four sessions was done |
Christensen et al. [12] | 97 | – | EILOMEA | EILOMEA is diagnostic software used to objectively describe images gained by CLE test. Evaluation of this software was performed to evaluate the reproducibility and clinical applications of this tool for the diagnosis of EIL and EIVCD | Nighty seven subjects aged between 14 and 24 had CLE testing performed. An expert assessed the severity of EIL and/or EIVCD for each laryngoscopic recording and compared this with data from EILOMEA |
Chiang et al. [8] | 93 | – | FFL | Single institution retrospective review and cohort analysis was performed to review the diagnostics and treatment of EPVFM | Single-institution retrospective review identifying patients with EPVFM was done. FFL performed on these patients were reviewed with regarding the presence of laryngeal pathology and the presence of PVFMD at rest and/or with exertion. Symptom outcomes were graded as complete resolution, improvement, or unchanged following therapy |
Roksund et al. [1] | 151 | 20 | CLE | Aimed to study transnasal laryngoscopic evaluation of laryngeal function during treadmill exercise |
Flow volume loops
Study | Number of patients | Number of controls | Diagnostic methods | Aims | Methodology |
---|---|---|---|---|---|
Christensen and Rasmussen [4] | 39 | – | EVH compared to CLE | To assess if a EVH test can produce laryngeal obstructions laryngoscopically identical in subtypes and development as seen through an exercise test | EVH and CLE testing was done during the screening of two national athletic teams( n = 67). Laryngoscopic recordings were examined for usability, abnormalities and maximal supraglottic and glottic obstruction using Eilomea and CLE-score. The questions on ERRS were asked to each participant, and if symptoms that occured during each provocation matched those which occured during regular training. A total of 39 completed both tests |
Christensen et al. [15] | 100 | – | FVL compared to CLE | To compare physician assessed pre- and post-exercise flow-volume loops and flow data with laryngoscopic findings during exercise | Data from 100 consecutive CLE-tests were analysed. Laryngoscopic images were compared with the corresponding pre- and post-exercise flow-volume loops assessed by four separate physicians |
Olin et al. [9] | 23 | – | FVL | The objective of this study was to highlight a group of patients who demonstrated important clinical findings of EIPVFM (exertional dyspnea with audible stridor) without simultaneously definitive physiologic findings (mild glottic adduction and normal flow volume loops) | We reviewed the records of 23 patients who performed continuous laryngoscopy during exercise. 3 blinded physicians independently evaluated isolated audio tracks, video tracks, and flow volume loops of the patients for stridor, glottic configuration, and the presence of inspiratory limitation on exercise flow volume loops at peak work capacity |
Non surgical treatment
Surgical treatment
Study | Number of patients | Number of controls | Treatment method | Aims | Methodology |
---|---|---|---|---|---|
Maat et al. [13] | 10 | – | ES with laser incision in both aryepiglottic folds anterior to the cuneiform cartilages and removal of the mucosa around the upper parts of the tubercles | Evaluate the usefulness of the CLE-test as a method for selecting patients for surgical intervention and evaluating treatment effects postoperatively | Ten patients underwent ES. CLE- test was done on each patient before and 3 months after surgery |
Chiang et al. [8] | 96 | – | LCT | The aim was to see of LCT was an effective treatment for EPVFMD | Patients diagnosed with PVFMD via FFL as well as symptoms with exercise were selected. Therapy was reviewed and symptoms outcomes were graded as complete resolution, improvement or unchanged following therapy |
Maat et al. [2] | 23 surgically treated patients with (ST) | 71 conservatively treated patients with breathing exercise (CT) | Laser supraglottoplasty | Reveal the natural history of supraglottic EILO and compare the symptoms, and the function of the larynx in conservatively versus surgically treated patients | Follow-up study of supraglottic EILO was performed. In 94 patients with predominantly supraglottic obstruction a questionnaire-based survey was conducted 2–5 years after EILO diagnosis via CLE test. Seventy-one patients had CT and 23 had ST. A second CLE test was carried out in 14 CT and 19 ST patients |