CPET in the PDA-surgery group was performed with concomitant continuous transnasal flexible video-laryngoscopy (ENF TYPE V2, video processor CV-170, OLYMPUS, Tokyo, Japan) as described previously (22 (link)). LVCP was identified and later verified by laryngeal stroboscopy. The video recordings of the laryngeal inlet during treadmill running were assessed and rated for laryngeal obstruction according to a modified version of the classification described by Maat et al. (23 (link)). Because of laryngeal asymmetry in subjects with LVCP, a modified CLE-score (0–24 points) was developed, assessing the right and left glottic and supraglottic areas separately. The visually assessed medial rotation of the aryepiglottic folds and medialization of the vocal folds were scored ranging from normal (0 points) to maximal (3 points) at moderate (fast walking) and at maximal effort. The left and right sides were scored separately. The total modified CLE-score was the sum of the sub-scores at moderate and maximal exercise.
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