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Area of Science:

  • Anesthesiology
  • Pulmonology
  • Otolaryngology

Background:

  • Upper airway stenosis (UAS) poses a significant risk for anesthesiologists, potentially leading to life-threatening complications if undiagnosed.
  • Patients with UAS often present with severe dyspnea or airway management challenges.

Purpose of the Study:

  • To assess the utility of lung function tests in differentiating Upper airway stenosis (UAS) from obstructive pulmonary diseases (OPDs).
  • To investigate the correlation between lung function parameters and the severity of UAS.

Main Methods:

  • Retrospective case series of patients with UAS.
  • Computed tomography (CT) scans and direct endoscopy were used to quantify stenosis severity.
  • Lung function tests were performed, with values expressed as a percentage of predicted reference values.

Main Results:

  • Median stenosis was 73%, with 70% of patients classified as Cotton-Myer grade 3.
  • Lung function tests revealed obstructive pulmonary disease-like parameter shifts.
  • Higher grade stenosis correlated with significantly increased residual volume (RV)/total lung capacity (TLC) ratio (P < .05).

Conclusions:

  • An elevated RV/TLC ratio with a normal forced expiratory volume in 1 second/vital capacity (FEV1/VC) can help distinguish symptomatic UAS from common OPD.
  • The RV-TLC ratio may serve as a tool to differentiate between low- and high-grade UAS.
  • Further epidemiological studies are needed for validation.