Tuberc Respir Dis.  2001 Sep;51(3):270-274. 10.4046/trd.2001.51.3.270.

A Case of Functional Upper Airway Obstruction Due to Vocal Cord Dysfunction in Obstructive Pulmonary Disease

• Oh M
• Kim SC
• Baik JJ
• Chung YT

• KMID: 2160015
• DOI: http://doi.org/10.4046/trd.2001.51.3.270

Abstract

A functional upper airway obstruction due to a vocal cord dysfunction(VCD) is characterized by a paradoxical adduction of the vocal cords throughout the respiratory cycle with no obvious organic cause for the obstruction. It commonly occurs paroxysmally and imitates acute asthmatic attacks, often in patients with coexisting asthma. They present with episodes of dyspnea associated with inspiratory wheezing that persists despite conventional asthma treatment and a flattening of the inspiratory limb of the flow-volume curve; an adduction of the vocal cord during inspiration. Failure to recognize concurrent vocal cord dysfunction and asthma has led not only to the excessive use of bronchodilators and corticosteroids, but also to intubation and tracheostomy. Here, we report a case of coexistent obstructive pulmonary disease and functional upper airway obstruction due to a vocal cord dysfunction where a bronchoscopy showed a paradoxical vocal cord motion and typical features of a variable extrathoracic obstruction and a lower airway obstruction on the Flow-volume loop during a symptomatic period.

Keyword

Asthma; Functional upper airway obstruction; Vocal cord dysfunction

MeSH Terms

Adrenal Cortex Hormones
Airway Obstruction*
Asthma
Bronchodilator Agents
Bronchoscopy
Dyspnea
Extremities
Humans
Intubation
Lung Diseases, Obstructive*
Respiratory Sounds
Tracheostomy
Vocal Cord Dysfunction*
Vocal Cords*
Adrenal Cortex Hormones
Bronchodilator Agents