Some athletes may develop laryngeal obstruction during exercise. It is important to distinguish this condition from other causes of exercise-induced dyspnea such as bronchoconstriction.


Clinical features:

(1) exercise-induced dyspnea with or without wheezing

(2) obstruction of the larynx

(3) evidence of airway obstruction seen on continuous laryngoscopy


Obstruction may be:

(1) supraglottic (involving the arytenoids and supporting structures)

(2) glottic (vocal cord dysfunction, other)


Structural causes may include laryngomalacia or laryngochalacia.


The condition may be misdiagnosed as exercise-induced bronchoconstriction. A clue in these patients is that the use of asthma medications is not associated with clinical improvement.


The diagnosis can easily be missed, especially if continuous laryngoscopy is not performed.


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