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Brief upper airway (laryngeal) dysfunction.

A H Campbell1, H Mestitz, R Pierce

  • 1Thoracic Department, Repatriation General Hospital, Heidelberg West, VIC, Australia.

Australian and New Zealand Journal of Medicine
|October 1, 1990
PubMed
Summary
This summary is machine-generated.

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Recurrent episodes of sudden breathing obstruction and inspiratory stridor in men are likely caused by involuntary laryngeal closure. Management focuses on reducing airway irritation and cough suppression.

Area of Science:

  • Respiratory Medicine
  • Laryngology

Background:

  • Recurrent episodes of sudden, brief complete obstruction to respiration followed by dyspnoea with loud inspiratory stridor lasting two to five minutes were observed.
  • Attacks occurred during wakefulness and/or sleep in six men over months or years.

Observation:

  • Endoscopic visualization in one patient revealed initial complete laryngeal closure, followed by false vocal cord opening but persistent vocal cord adduction causing inspiratory stridor.
  • Patients could voluntarily simulate episodes by adducting their vocal cords, suggesting a similar mechanism.

Findings:

  • The symptoms were often preceded by throat irritation and, in some cases, upper respiratory infection, post-nasal discharge, snoring, sleep apnoea, and gastro-oesophageal reflux.
  • The condition, likely due to laryngeal closure, differs from typical cough reflex responses to laryngeal receptor stimulation.

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Implications:

  • Recognizing this laryngeal closure disorder is crucial as it can be misdiagnosed as other causes of acute dyspnoea.
  • Treatment involving reduction of upper airway irritation and voluntary cough inhibition proved effective in reducing episode frequency and severity.