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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2000 September-December;39(3-4):95-104
Chronic obstruction of the central airways. A study of 28 cases
Vernocchi S., Ghiringhelli P.
Background. The aim of this study was to identify the clinical signs or most sensitive and specific tests for chronic airway obstruction.
Methods. A total of 28 patients with central airway obstruction were examined. The duration of disorders prior to diagnosis varied between 11 months and 11 years. Of these, 9 were treated for intrinsic asthma, 12 for BPCO, 2 for effort asthma, 1 for spastic neurosis, 1 initially for intrinsic asthma and subsequently for nocturnal apnea and lastly 1 initially for BPCO and subsequently for nocturnal apnea. A suspected diagnosis was made in 27 out of the 28 patients examined. The following signs were particularly indicative: the palpation of rhonchi on the larynx and thachea, and the auscultation of stridor, predominantly inspiratory and expecially under effort, particularly audible on the neck and the manubrium sterni. The obstruction was caused by a number of factors, including scarring, inflammatory granuloma, malformations, lack of motor coordination, extrinsic compression, sequelae to trauma and endoluminal neoplasms. The obstruction was localised at a tracheal level in 19 cases, in the pharynx in 2 cases, in the larynx in 6 cases and in 1 case at the level of the larynx and the first tracheal ring.
Results. The results of the various treatments were excellent in 17 patients, good in three and moderate in a further three patients.
Conclusions. Respiratory function tests, widely used for the diagnosis of central airway obstruction, were not very useful compared to clinical examination and only allowed a suspected diagnosis to be made in one case.