EILO: Diagnosis

A detailed evaluation is needed to correctly diagnose vocal cord dysfunction (VCD) and exercise-induced laryngeal obstruction (EILO) and to determine effective methods of treatment.

Ways to diagnose VCD and EILO include:

• Exam and history: Your health care provider will complete a detailed medical history and physical exam.

• Spirometry: Breathing tests like spirometry can be useful in diagnosing VCD and EILO, but only if they are done when symptoms are occurring. In the absence of any symptoms or other complicating conditions like asthma, breathing tests for VCD and EILO may be normal.   However, if spirometry is conducted when symptoms are present, and the doctor obtains what is called a “flow volume loop,” VCD will cause a flattening of the inspiratory and/or expiratory part of the loop.

• Laryngoscopy: Laryngoscopy can be useful in diagnosing VCD and EILO, but generally only if it is done when symptoms are occurring. It is now possible to perform laryngoscopy simultaneous to the introduction of triggers that are specifically problematic to one person.

• Continuous laryngoscopy during exercise: We are one of a few centers in the world that can readily perform continuous laryngoscopy during exercise, a procedure which enables the visualization of the upper airway during intense exercise. This test is used in the evaluation of EILO. To date, we have performed the test more than 500 times in people ranging in age from 6 to 72.

• Speech consultation: Speech therapy can also be useful in diagnosing the condition. As symptoms must be present during laryngoscopy or spirometry to accurately diagnose VCD, sometimes the inappropriate airway restriction is missed during testing because it wasn’t provoked. A speech-language pathologist who specializes in VCD can assess a patient’s history, symptoms and treatment response to determine whether VCD is present, while concurrently beginning therapy.