UPPER AIRWAY-OBSTRUCTION - REPORT ON 16 PATIENTS

Google Scholar
  • 1 January 1976
    • journal article
    • research article
    • Vol. 45  (180) , 625-645
Abstract
In 16 patients with upper airway obstruction, breathlessness was a symptom in all with maximum mid vital capacity flow rates in inspiration or expiration of 1.7 l/s or less. With 1 exception, all these patients had stridor. There was no diagnostic difficulty in the 12 patients with extrathoracic airway obstruction and in this group, tests of inspiratory flow were of most value in following the progression of the disease and the response to treatment. Flow volume loops were particularly useful where extrathoracic obstruction and diffuse intrapulmonary airway obstruction co-existed. The 2 patients with intrathoracic upper airway obstruction caused considerable difficulty with diagnosis and both were initially thought to have, and treated unsuccessfully for, asthma. In each patient flow volume loops showed a low flow expiratory plateau, diagnostic of severe intrathoracic airway obstruction but recorded in the absence of any clinical or radiographic features of emphysema. An obstructing lesion of the intrathoracic trachea was suspected and this was confirmed by tracheal tomography. In 1 patient serial expiratory flow volume curves demonstrated the combination of intrathoracic upper and lower airway obstruction. Two patients had tracheal stenosis in the region of the suprasternal notch. Each showed a characteristic twin humped expiratory flow volume curve and in 1 patient the stenosis was demonstrated both physiologically and radiologically to move in and out of the thorax. The ratio of forced expired volume in 1 s measured in milliliters, to the peak expiratory flow measured in l/min, was of limited value in differentiating upper from lower airway obstruction in these patients.

This publication has 2 references indexed in Scilit: