Skip to main content
The Egyptian Journal of Internal Medicine
Download PDF

Pulmonary function test in upper airway obstruction: a simple yet effective diagnostic test

The Egyptian Journal of Internal Medicine volume 31, pages 243–246 (2019)Cite this article

Abstract

Upper airway obstruction (UAO) is a dangerous condition that is associated with significant mortality. It is easily diagnosed when its presentation is acute, but subacute or chronic presentation may pose a diagnostic dilemma resulting in disastrous consequences. Clinical evaluation may provide subtle clues towards its presence, whereas pulmonary function test can provide useful information to confirm the presence and site of UAO. Relevant radiological and endoscopic investigation may then be carried out to identify the exact etiology and institute appropriate therapy. We present a case of chronic UAO that was detected with the help of pulmonary function test and confirmed with computed tomography and endoscopy. The etiology was found to be related to fibrosis of the larynx resulting in the immobility of the vocal cords secondary to radiotherapy given to the patient 7 years ago. This is an unusual presentation, as most of the radiotherapy-related fibrosis in the head and neck region present within a few months of the exposure to radiation.

References

  1. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26:948–968.

    Article  CAS  Google Scholar 

  2. Modrykamien AM, Gudavalli R, McCarthy K, Liu X, Stoller JK. Detection of upper airway obstruction with spirometry results and the flow-volume loop: a comparison of quantitative and visual inspection criteria. Respir Care 2009; 54:474–479.

    PubMed  Google Scholar 

  3. Golish JA, Ahmad M, Yarnal JR. Chronic upper airway obstruction. Methods of detection and recognition. Cleve Clin Q 1980; 47:9–15.

    Article  CAS  Google Scholar 

  4. France JE, Thomas MJC. Clinical use of the Empey index in the emergency department. Emerg Med J 2004; 21:642–643.

    Article  CAS  Google Scholar 

  5. Miller RD, Hyatt RE. Evaluation of obstructing lesions of the trachea and larynx by flow-volume loops. Am Rev Respir Dis 1973; 108:475–481.

    CAS  PubMed  Google Scholar 

  6. Guntupalli KK, Bandi V, Sirgi C, Pope C, Rios A, Eschenbacher W. Usefulness of flow volume loops in emergency center and ICU settings. Chest 1997; 111:481–488.

    Article  CAS  Google Scholar 

  7. Karkhanis VS, Desai U, Joshi JM. Flow volume loop as a diagnostic marker. Lung India 2013; 30:166–168.

    Article  Google Scholar 

  8. Gibson GJ. Central airway obstruction and bronchial carcinoma. In: Gibson GJ, editor. Clinical tests of respiratory function. 3rd ed. New Delhi: Jaypee Brothers; 2009. 221–234.

    Google Scholar 

  9. Eckel HE, Sittel C. Bilateral recurrent laryngeal nerve paralysis. HNO 2001; 49:166–179.

    Article  CAS  Google Scholar 

  10. Prepageran N, Raman R. Delayed complication of radiotherapy: laryngeal fibrosis and bilateral vocal cord immobility. Med J Malaysia 2005; 60:377–378.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Pulmonary Medicine Unit, Salmaniya Medical Complex, Manama, 351, Kingdom of Bahrain

    Amit Panjwani DM, MD, DNB, MBBS

  2. Royal College of Surgeons, Ireland Medical University of Bahrain, Busaiteen, Kingdom of Bahrain

    Amit Panjwani DM, MD, DNB, MBBS

  3. Department of Pulmonary Medicine, Seven Hills Hospital, Mumbai, Maharashtra, India

    Amit Panjwani DM, MD, DNB, MBBS

  4. Department of Otorhinolaryngology, Seven Hills Hospital, Mumbai, Maharashtra, India

    Jaini Lodha

Authors
  1. Amit Panjwani DM, MD, DNB, MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaini Lodha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amit Panjwani DM, MD, DNB, MBBS.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Panjwani, A., Lodha, J. Pulmonary function test in upper airway obstruction: a simple yet effective diagnostic test. Egypt J Intern Med 31, 243–246 (2019). https://doi.org/10.4103/ejim.ejim_100_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejim.ejim_100_18

Keywords