| Diagnosis of vocal cord dysfunction in asthma with high resolution dynamic volume computerized tomography of the larynx. | |
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MedLine Citation:
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PMID: 19708903 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Vocal cord dysfunction (VCD) often masquerades as asthma and reports have suggested that up to 30% of patients with asthma may have coexistent VCD. Diagnosis of VCD is difficult, in part because it involves laryngoscopy which has practical constraints, and there is need for rapid non-invasive diagnosis. High speed 320-slice volume CT demonstrates laryngeal function during inspiration and expiration and may be useful in suspected VCD. METHODS: Endoscopy and high resolution 320-slice dynamic volume CT were used to examine and compare laryngeal anatomy and movement in a case of subglottic stenosis and in a patient with confirmed VCD. Nine asthmatics with ongoing symptoms and suspected VCD also underwent 320-slice dynamic volume CT. Tracheal and laryngeal anatomy and movement were evaluated and luminal areas were measured. Reductions in vocal cord luminal area >40%, lasting for >70% duration of inspiration/expiration, were judged to be consistent with VCD. RESULTS: Studies of subglottic tracheal stenosis validated anatomical similarities between endoscopy and CT images. Endoscopy and 320-slice volume CT also provided comparable dynamic images in a patient with confirmed VCD. A further nine patients with a history of severe asthma and suspected VCD were studied using CT. Four patients had evidence of VCD and the median reduction of luminal area during expiration was 78.2% (range 48.2-92.5%) compared with 10.4% (range 4.7-30%) in the five patients without VCD. Patients with VCD had no distinguishing clinical characteristics. CONCLUSIONS: Dynamic volume CT provided explicit images of the larynx, distinguished function of the vocal cords during the respiratory cycle and could identify putative VCD. The technique will potentially provide a simple, non-invasive investigation to identify laryngeal dysfunction, permitting improved management of asthma. |
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Authors:
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Peter W Holmes; Kenneth K Lau; Marcus Crossett; Cathy Low; Douglas Buchanan; Garun S Hamilton; Philip G Bardin |
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Publication Detail:
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Type: Journal Article Date: 2009-08-25 |
Journal Detail:
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Title: Respirology (Carlton, Vic.) Volume: 14 ISSN: 1440-1843 ISO Abbreviation: Respirology Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9616368 Medline TA: Respirology Country: Australia |
Other Details:
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Languages: eng Pagination: 1106-13 Citation Subset: IM |
Affiliation:
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Respiratory & Sleep Medicine, Diagnostic Imaging and Surgery, Monash University and Medical Centre, Melbourne, Victoria, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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