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(Chest. 1996;110:1358-1361.)
© 1996 American College of Chest Physicians

Coexistent Asthma and Functional Upper Airway Obstruction

Case Reports and Review of the Literature

Ashraf A. Elshami MD1 and Gregory Tino MD1

1 From the Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia

Three asthmatic patients with dyspnea and episodes of apparent bronchospasm unresponsive to conventional therapy are described. During these episodes variable extrathoracic upper airway obstruction and airflow limitation typical of bronchial asthma were demonstrated by spirometry test results. In one patient, paradoxical vocal cord motion was identified by fiberoptic laryngoscopy. We believe these patients represent an unusual subgroup of asthmatic subjects who manifest laryngeal dysfunction. Recognition of this upper airway component to airflow limitation in some asthmatic patients may help physicians avoid potentially unnecessary therapy with systemic steroids and endotracheal intubation.

Key Words: asthma • laryngeal dysfunction • paradoxical vocal cord motion • stridor • upper airway obstruction

Submitted on July 31, 1995
Accepted on April 24, 1996




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