Clinical Profiles of Children and Adolescents With Induced Laryngeal Obstruction (ILO) and Exercise Induced Laryngeal Obstruction (EILO).

Purpose: To compare clinical profiles of pediatric patients with Induced Laryngeal Obstruction (ILO), Exercise Induced Laryngeal Obstruction (EILO), and EILO with non-exertion related secondary triggers (EILO+).

Methods: A retrospective observational cohort design was employed. Four-hundred and twenty-three patients <18 years of age were identified from the electronic medical record of a large children's hospital. All patients underwent evaluations with a laryngologist and speech-language pathologist and were diagnosed with EILO/ILO. Patients were divided into 3 groups based on dyspnea triggers reported in initial evaluations. Groups consisted of patients with EILO (N = 281), ILO (N = 30), and EILO+ (N = 112). Patient demographics, EILO/ILO symptoms, endoscopy findings, medical comorbidities, medical history, and EILO/ILO treatment information were extracted and compared across EILO/ILO subtypes.

Results: Patients with EILO experienced higher rates of hyperventilation ( < .001), sore throat ( = .023), and chest pain ( = .003). Patients with ILO were significantly younger in age ( = .017) and presented with increased rates of nighttime symptoms ( < .001), globus sensation ( = .008), self-reported reflux symptoms ( = .023), and history of gastrointestinal conditions ( = .034). Patients with EILO+ were more likely to be female ( = .037) and presented with higher prevalence of anxiety ( = .003), ADHD ( = .004), chest tightness ( = .030), and cough ( < .001).

Conclusions: Patients with EILO, ILO, and EILO+ present with overlapping but unique clinical profiles. A prospective study is warranted to determine the etiology of these differences and clarify how the efficacy of EILO, ILO, and EILO+ treatment can be maximized.

Level Of Evidence: 4.