Exercise-induced laryngomalacia

Exercise-induced laryngomalacia (EIL) is characterized by severe dyspnea, stridor, and mild wheezing unresponsive to prophylactic treatment with β-agonists and cromolyn sodium. Symptoms develop with extreme exertion, but resolve quickly as the degree of exercise is decreased. Diagnosis requires flexible fiberoptic laryngoscopy before, during, and after exercise. If the diagnosis of EIL is confirmed by laryngoscopy during maximal exercise, laser epiglottoplasty is effective in alleviating symptoms and improving the airway. However, because symptoms develop only during maximal exertion, EIL is unlikely to produce symptoms or functional disability in persons who lead relatively sedentary lives.