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Related Concept Videos

Larynx01:21

Larynx

The human larynx, often referred to as the voice box, is an intricate organ located in the neck. It serves as a pathway for air to enter the lungs during respiration and is an essential component of voice production.
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Pulmonary Function Tests

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Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
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Clinical and lung-function variables associated with vocal cord dysfunction.

Maura A Watson1, Christopher S King, Aaron B Holley

  • 1Pulmonary and Critical Care Medicine, Walter Reed Army Medical Center, 3831 Rodman Street NW, F30, Washington DC 20016, USA.

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|March 31, 2009
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Summary
This summary is machine-generated.

Diagnosing vocal cord dysfunction (VCD) is challenging. While female sex and obesity are predictors, spirometry and flow-volume loops are not reliable for predicting VCD.

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Area of Science:

  • Pulmonology
  • Respiratory Medicine
  • Diagnostic Medicine

Background:

  • Vocal cord dysfunction (VCD) presents diagnostic challenges.
  • Laryngoscopy during symptomatic periods is the gold standard for VCD diagnosis.
  • Identifying predictive clinical and spirometric variables for VCD is crucial.

Purpose of the Study:

  • To identify clinical and spirometric variables that can predict the presence of VCD.
  • To evaluate the utility of spirometry and flow-volume loops in diagnosing VCD.
  • To determine predictors of VCD through multivariate logistic regression.

Main Methods:

  • Two parallel studies were conducted, including pulmonologist assessment of flow-volume loops and a cross-sectional study of clinical/spirometric data.
  • Pulmonologists evaluated flow-volume loops for VCD likelihood, blinded to laryngoscopy results.
  • Multivariate logistic regression analyzed laryngoscopy findings against clinical characteristics and spirometry.

Main Results:

  • Pulmonologist agreement on VCD prediction from flow-volume loops was moderate but not predictive of laryngoscopic diagnosis.
  • VCD was diagnosed in 44% of 226 patients undergoing laryngoscopy.
  • Independent predictors of VCD included female sex (OR 2.72) and obesity (OR 2.06).
  • The ratio of forced inspiratory flow at 25% to 75% of inspired volume (FIF(25%/75%)) showed some predictive value (OR 1.97), but overall diagnostic performance was poor (AUC 0.68).
  • No spirometric variables predicted VCD when controlling for inspiratory curve reproducibility.

Conclusions:

  • Vocal cord dysfunction (VCD) remains difficult to predict using spirometry or flow-volume loops.
  • Normal flow-volume loop patterns should not deter laryngoscopy if VCD is suspected.