Clin Exp Otorhinolaryngol.  2015 Jun;8(2):161-166. 10.3342/ceo.2015.8.2.161.

Changes in the Flow-Volume Curve According to the Degree of Stenosis in Patients With Unilateral Main Bronchial Stenosis

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea. hjk3425@skku.edu
  • 2Korea Institute for Industrial Economics and Trade, Seoul, Korea.
  • 3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hjk3425@skku.edu

Abstract


OBJECTIVES
The shape of the flow-volume (F-V) curve is known to change to showing a prominent plateau as stenosis progresses in patients with tracheal stenosis. However, no study has evaluated changes in the F-V curve according to the degree of bronchial stenosis in patients with unilateral main bronchial stenosis.
METHODS
We performed an analysis of F-V curves in 29 patients with unilateral bronchial stenosis with the aid of a graphic digitizer between January 2005 and December 2011.
RESULTS
The primary diseases causing unilateral main bronchial stenosis were endobronchial tuberculosis (86%), followed by benign bronchial tumor (10%), and carcinoid (3%). All unilateral main bronchial stenoses were classified into one of five grades (I, < or =25%; II, 26%-50%; III, 51%-75%; IV, 76%-90%; V, >90% to near-complete obstruction without ipsilateral lung collapse). A monophasic F-V curve was observed in patients with grade I stenosis and biphasic curves were observed for grade II-IV stenosis. Both monophasic (81%) and biphasic shapes (18%) were observed in grade V stenosis. After standardization of the biphasic shape of the F-V curve, the breakpoints of the biphasic curve moved in the direction of high volume (x-axis) and low flow (y-axis) according to the progression of stenosis.
CONCLUSION
In unilateral bronchial stenosis, a biphasic F-V curve appeared when bronchial stenosis was >25% and disappeared when obstruction was near complete. In addition, the breakpoint moved in the direction of high volume and low flow with the progression of stenosis.

Keyword

Maximal Expiratory Flow-Volume Curves; Spirometry; Bronchi

MeSH Terms

Bronchi
Carcinoid Tumor
Constriction, Pathologic*
Humans
Lung
Maximal Expiratory Flow-Volume Curves
Spirometry
Tracheal Stenosis
Tuberculosis

Figure

  • Fig. 1 Representative cases (A), median graph (B), and the expiratory pattern of the flow-volume curve (C) according to the degree of stenosis.

  • Fig. 2 Standardized graph using the median value of the breakpoint according to the degree of stenosis. The more advanced the unilateral bronchial stenosis, the more the breakpoint moved from top to bottom and from inside to outside on the x-axis (volume) and y-axis (flow), respectively. F-V, flow-volume; FVC, forced vital capacity.


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