Inducible laryngeal obstruction: Endoscopic quantitative analysis of glottic aperture

Objectives Using a method developed for this study, the objective was to perform a quantitative analysis of glottic aperture during the respiratory cycle in subjects suspected of having inducible laryngeal obstruction (ILO) and to compare results to healthy individuals. Correlations between glottic...

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Bibliographic Details
Published in:The Laryngoscope 2020-05, Vol.130 (5), p.E349-E356
Main Authors: Henrique Peitl Gregorio, Paulo, Teixeira Gomes, Juliana, Rodrigues, Roberto, Jacomelli, Marcia, Samara Santos, Ellen, Gervilla Gregorio, Marcelo
Format: Article
Language:English
Subjects:
endoscopic quantitative evaluation
Inducible laryngeal obstruction
Larynx
pulmonary function test
Quantitative analysis
Throat
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Summary:Objectives Using a method developed for this study, the objective was to perform a quantitative analysis of glottic aperture during the respiratory cycle in subjects suspected of having inducible laryngeal obstruction (ILO) and to compare results to healthy individuals. Correlations between glottic aperture and spirometric parameters were assessed. Methods Subjects with high clinical suspicion of ILO and atypical inspiratory findings in spirometry had the images of their laryngoscopy displayed alongside a respiratory flow chart and both were recorded simultaneously. This method allowed detailed analysis of the glottic aperture by measuring the angle of the anterior commissure during inspiration and expiration. Healthy volunteers who performed the same tests and agreed to provide data to this study were used as a control group. Results All 15 subjects with ILO and 16 healthy participants were evaluated successfully using the proposed method. Measures of the anterior commissure angle in the ILO versus control group were significantly different in all observed parameters and just three ILO subjects had an anterior commissure closure greater than 50% during the respiratory cycle. Inspired volume (FIF50) and mid‐vital capacity ratio (FEF50/FIF50) had a significant correlation with glottic aperture parameters when considering the evaluation of the subjects all together. Conclusion The proposed method provided precise and quantitative analysis of glottic aperture during the respiratory cycle thus indicating that the usage of equipment that allows for such assessment should be encouraged. Also, the threshold of vocal cords closure accepted as indicative of ILO should be reconsidered, especially during the intercritical period of the disease. Level of Evidence 4 Laryngoscope, 130:E349–E356, 2020
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28213