The Study of Laryngoscopic and Autonomic Patterns in Exercise-Induced Laryngeal Obstruction

Adrianna C. Shembel, Christopher J. Hartnick, Glenn Bunting, Catherine Ballif, Jessie Vanswearingen, Susan Shaiman, Aaron Johnson, Vanessa de Guzman, Katherine Verdolini Abbott

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objectives: (1) Identify laryngeal patterns axiomatic to exercise-induced laryngeal obstruction (EILO) and (2) investigate the role of autonomic function in EILO. Methods: Twenty-seven athletic adolescents (13 EILO, 14 control) underwent laryngoscopy at rest and exercise. Glottal configurations, supraglottic dynamics, systolic blood pressure responses, and heart rate recovery were compared between conditions and groups. Results: Inspiratory glottal angles were smaller in the EILO group than the control group with exercise. However, group differences were not statistically significant (P >.05), likely due to high variability of laryngeal responses in the EILO group. Expiratory glottal patterns showed statistically greater abductory responses to exercise in the control group (P =.001) but not the EILO group (P >.05). Arytenoid prolapse occurred variably in both groups. Systolic blood pressure responses to exercise were higher in the control group, and heart rate recovery was faster in the EILO group. However, no significant differences were seen between the 2 groups on either autonomic parameter (P >.05). Conclusions: “Paradoxical” inspiratory and blunted expiratory vocal fold pattern responses to exercise best characterize EILO. Group differences were only seen with exercise challenge, thus highlighting the utility of provocation and control groups to identify EILO.

Original languageEnglish (US)
Pages (from-to)754-762
Number of pages9
JournalAnnals of Otology, Rhinology and Laryngology
Issue number11
StatePublished - Nov 1 2018
Externally publishedYes


  • airway disorders
  • endoscopy
  • exercise
  • laryngeal physiology
  • laryngology
  • miscellaneous
  • otolaryngology
  • vocal cord dysfunction

ASJC Scopus subject areas

  • Otorhinolaryngology


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