Chronic Upper Airway Obstruction: Value of the Flow Volume Loop Examination in Assessment and Management

Overview

Journal J R Soc Med

Specialty General Medicine

Date 1982 Jun 1

PMID 7086791

Citations 5

Authors

G B Brookes

A J Fairfax

Affiliations

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Abstract

Chronic obstructive lesions of the upper airways such as post-traumatic strictures, bilateral vocal cord paralysis and chronic inflammatory foci are uncommon. The functional assessment of the severity and character of an obstruction is important both for diagnosis and management, and may also allow evaluation of the efficacy of medical and surgical treatment. There are limitations of simple spirometric pulmonary function tests, which are evident when assessing upper airways obstruction. The flow volume loop is a graphic recording of airflow during maximal respiration and expiration at different lung volumes, and may be affected in a characteristic way by alterations in the airway resistance. Three unusual cases of chronic upper airway obstruction are presented which illustrate the value of the flow volume loop examination in their management.

Citing Articles

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Assessment of lung ventilation of premature infants with bronchopulmonary dysplasia at 1.5 Tesla using phase-resolved functional lung magnetic resonance imaging.

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An increasingly breathless patient.

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Contribution of flow-volume curves to the detection of central airway obstruction.

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Flow volume loops in patients with goiters.

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References

Hyatt R, Flath R . Relationship of air flow to pressure during maximal respiratory effort in man. J Appl Physiol. 1966; 21(2):477-82. DOI: 10.1152/jappl.1966.21.2.477. View

Jordanoglou J, Pride N . A comparison of maximum inspiratory and expiratory flow in health and in lung disease. Thorax. 1968; 23(1):38-45. PMC: 471731. DOI: 10.1136/thx.23.1.38. View

Miller R, Hyatt R . Obstructing lesions of the larynx and trachea: clinical and physiologic characteristics. Mayo Clin Proc. 1969; 44(3):145-61. View

Pride N . The assessment of airflow obstruction. Role of measurements of airways resistance and of tests of forced expiration. Br J Dis Chest. 1971; 65:135-69. DOI: 10.1016/0007-0971(71)90018-0. View

Shim C, Corro P, Park S, WILLIAMS Jr M . Pulmonary function studies in patients with upper airway obstruction. Am Rev Respir Dis. 1972; 106(2):233-8. DOI: 10.1164/arrd.1972.106.2.233. View

Empey D . Assessment of upper airways obstruction. Br Med J. 1972; 3(5825):503-5. PMC: 1785761. DOI: 10.1136/bmj.3.5825.503. View

Miller R, Hyatt R . Evaluation of obstructing lesions of the trachea and larynx by flow-volume loops. Am Rev Respir Dis. 1973; 108(3):475-81. DOI: 10.1164/arrd.1973.108.3.475. View

Topham J, Empey D . Practical assessment of obstruction in the larynx and trachea. J Laryngol Otol. 1974; 88(12):1185-93. DOI: 10.1017/s0022215100079925. View

Rotman H, Liss H, Weg J . Diagnosis of upper airway obstruction by pulmonary function testing. Chest. 1975; 68(6):796-9. DOI: 10.1378/chest.68.6.796. View

10.

Holinger L, Holinger P, HOLINGER P . Etiology of bilateral abductor vocal cord paralysis: a review of 389 cases. Ann Otol Rhinol Laryngol. 1976; 85(4 Pt 1):428-36. DOI: 10.1177/000348947608500402. View

11.

Harrison B . Upper airway obstruction--a report on sixteen patients. Q J Med. 1976; 45(180):625-45. View

12.

Weisman R, Canalis R, Powell W . Laryngeal sarcoidosis with airway obstruction. Ann Otol Rhinol Laryngol. 1980; 89(1 Pt 1):58-61. DOI: 10.1177/000348948008900113. View

13.

FRY D, Hyatt R . Pulmonary mechanics. A unified analysis of the relationship between pressure, volume and gasflow in the lungs of normal and diseased human subjects. Am J Med. 1960; 29:672-89. DOI: 10.1016/0002-9343(60)90100-5. View

14.

Hyatt R, Wilcox R . Extrathoracic airway resistance in man. J Appl Physiol. 1961; 16:326-30. DOI: 10.1152/jappl.1961.16.2.326. View

15.

Hyatt R . The interrelationships of pressure, flow, and volume during various respiratory maneuvers in normal and emphysematous subjects. Am Rev Respir Dis. 1961; 83:676-83. DOI: 10.1164/arrd.1961.83.5.676. View

16.

NAIRN J, McNeill R . Adaptation of the Wright peak flow meter to measure inspiratory flow. Br Med J. 1963; 1(5341):1321-23. PMC: 2123932. DOI: 10.1136/bmj.1.5341.1321. View

17.

SCHIRATZKI H . UPPER AIRWAY RESISTANCE IN NORMAL MAN DURING MOUTH BREATHING. Acta Otolaryngol. 1964; 58:535-54. DOI: 10.3109/00016486409121414. View

18.

DEVINE K . SARCOIDOSIS AND SARCOIDOSIS OF THE LARYNX. Laryngoscope. 1965; 75:533-69. DOI: 10.1288/00005537-196504000-00001. View

19.

ROSS B, GRAMIAK R, Rahn H . Physical dynamics of the cough mechanism. J Appl Physiol. 1955; 8(3):264-8. DOI: 10.1152/jappl.1955.8.3.264. View