Myasthenic Inspiratory Vocal Cord Dysfunction: Efficacy of Nasal Continuous Positive Airway Pressure Treatment

Todisco, Tommaso; Baglioni, Stefano; Eslami, Akbar; Todisco, C; Dottorini, Maurizio

doi:10.1159/000029471

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…Two case reports have described myasthenia gravis patients with functional obstruction related to vocal cord weakness. 62,63 Symptoms resolved with use of continuous positive airway pressure in one patient. Mazza et al studied the FVL of 3 patients during conventional versus glossopharyngeal breathing and found a characteristic "saw-toothed" pattern of the inspiratory limb.…”

Section: Neuromuscular Diseasementioning

confidence: 98%

Inspiratory Flow Volume Loops and the Diagnosis of Upper Airway Obstruction

Pavel

Morris

Nicholson

et al. 2008

Clinical Pulmonary Medicine

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As part of the evaluation process of patients with pulmonary symptoms, the flow volume loop (FVL) may be important in identifying the presence of functional or anatomic airway abnormalities. Typical patterns in both the expiratory and inspiratory limbs help identify either restrictive or obstructive lung diseases. The inspiratory limb of the FVL has been advocated as a predictor for the presence of extrathoracic upper airway obstruction (UAO) in patients with associated symptoms. The recently published guidelines on pulmonary function testing interpretation emphasize FVL review for suspected UAO. It was first clinically described in the early 1970s by Miller and Hyatt in patients with known tracheal stenosis, airway tumors, and vocal cord paralysis. It can help to identify and manage some chronic anatomic causes of UAO such as goiter and vocal cord paralysis. Its usefulness as a diagnostic test is increasing in more functional upper airway diseases, such as vocal cord dysfunction or neuromuscular disease. This review carefully examines the available literature on the inspiratory FVL to identify those clinical entities in which it has proven to be a useful diagnostic test.

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Section: Neuromuscular Diseasementioning

confidence: 98%

Inspiratory Flow Volume Loops and the Diagnosis of Upper Airway Obstruction

Pavel

Morris

Nicholson

et al. 2008

Clinical Pulmonary Medicine

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Inhaled Corticosteroids May Reduce Neutrophilic Inflammation in Patients with Stable Chronic Obstructive Pulmonary Disease

Yıldız

Kaur²,

Ilgazlı³

et al. 2000

Respiration

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Background: Although both inhaled and oral corticosteroids have anti-inflammatory effects causing improvement in clinical symptoms and spirometry in the treatment of asthma, the role of corticosteroids in the management of chronic obstructive pulmonary disease (COPD) is controversial. Objective: To evaluate the effects of inhaled corticosteroids on sputum neutrophilia in clinically stable COPD patients. Methods: In total, 18 patients were enrolled in the study. During 2 months, 9 patients in group A inhaled fluticasone propionate (FP) 500 μg 3 times daily. In group B 9 patients received placebo. All of the patients continued to inhale both salbutamol and ipratropium bromide. In 9 patients, sustained-released theophylline was also administered. Blood samples, spirometric tests, blood gas analyses, and either spontaneous or induced sputum cultures were evaluated on entry into the study, after a 2 months of treatment and following the 6-week washout period. Results: After the 2-month FP treatment, no significant changes in the number of peripheral blood neutrophils, blood gas and spirometry data were observed in both groups. In group A, the total cell number and the number of neutrophils decreased from a mean of 3.4 ± 1.3 × 10⁶ cells/g and 0.6 ± 0.3 × 10⁶ neutrophils/g on entry into study to 1.9 ± 0.6 × 10⁶ cells/g and 0.02 ± 0.01 × 10⁶ neutrophils/g after 8-week treatment with FP, returning to 3.3 ± 1.1 × 10⁶ cells/g and 0.5 ± 0.3 × 10⁶ neutrophils/g following the washout period. The percentages of neutrophils were 55.6 and 77.9% in groups A and B after 2 months of FP treatment. There was no significant change in group B values during the study. Conclusion: These data suggest that neutrophilic inflammation in sputum may be decreased by inhaled corticosteroids in clinically stable COPD patients.

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磯貝¹

2006

The Journal of the Japan Broncho-esophagological Society

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Myasthenic Inspiratory Vocal Cord Dysfunction: Efficacy of Nasal Continuous Positive Airway Pressure Treatment

Cited by 4 publications

References 21 publications

Inspiratory Flow Volume Loops and the Diagnosis of Upper Airway Obstruction

Inspiratory Flow Volume Loops and the Diagnosis of Upper Airway Obstruction

Inhaled Corticosteroids May Reduce Neutrophilic Inflammation in Patients with Stable Chronic Obstructive Pulmonary Disease

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