Abnormal movement of the arytenoid region during exercise presenting as exercise-induced asthma in an adolescent athlete

Abstract

A 16-year-old female basketball player presented with a 2 1/2 -year history of exercise-induced severe dyspnea, stridor, and mild wheezing that did not respond to prophylactic treatment with β-agonists and cromolyn. Spirometric data at rest were normal, but flow-volume loops during exercise suggested a variable extrathoracic obstruction. Laryngoscopic evaluation while the patient was riding an exercise bicycle demonstrated an abnormal motion of the arytenoid region causing obstruction of the airway during inspiration. The vocal cords moved normally. This patient demonstrates the capacity of supraglottic tissue to obstruct the airway during exercise as a cause for exercise-induced dyspnea and stridor. Patients with this disorder may be misdiagnosed as having exercise-induced asthma.