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Journal of Asthma Volume 59, 2022 - Issue 6
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Comorbid Conditions

Vocal cord dysfunction detected by a three-dimensional image of dynamic change in respiratory resistance in a patient with difficult-to-treat asthma: a case report

Ayaka Odaa Postgraduate Clinical Training Center, Hiroshima University, Hiroshima, Japan
, MD,
Toshihito Otanib Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD,
Hiroshi Iwamotob Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0003-4922-5334
, MD, PhDORCID Icon,
Manabu Nishidac Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
, MD,
Yuichiro Horibec Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Kakuhiro Yamaguchib Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Shinjiro Sakamotob Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Yasushi Horimasub Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Takeshi Masudab Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Shintaro Miyamotob Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Taku Nakashimab Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Kazunori Fujitakab Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Hironobu Hamadad Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Sachio Takenoc Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD &
Noboru Hattorib Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD show all
Pages 1157-1161 | Received 11 Nov 2020, Accepted 24 Mar 2021, Published online: 14 Apr 2021
 
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Abstract

Introduction

Vocal cord dysfunction (VCD) often coexists with asthma and exacerbates respiratory symptoms. A noninvasive method could be considered beneficial for the detection and follow-up of VCD complicated by asthma. Here, we report a case of VCD complicated by asthma, highlighting the effectiveness of colored three-dimensional (3-D) imaging of respiratory impedance using a broadband frequency forced oscillation technique (MostGraph).

Case Study

A 74-year-old woman with difficult-to-treat asthma, in whom mepolizumab treatment was ineffective, was referred to our hospital. Stridulous sounds were loudest over the anterior neck. Pulmonary function tests’ results were normal; however, a flattening of the inspiratory flow-volume curve was detected.

Results

Remarkably, prominent spikes were observed in the inspiratory phase in the colored 3-D imaging of respiratory resistance, which was superimposed on increased respiratory resistance in the expiratory phase. Flexible laryngoscopy revealed the adduction of vocal cords on inspiration. The patient was diagnosed with asthma complicated by VCD. After successful treatment of VCD by speech therapy, inspiratory spikes of respiratory resistance disappeared, and normal vocal cord movement was observed on laryngoscopy.

Conclusion

The present case report indicates the effectiveness of forced oscillometry in evaluating dynamic changes in respiratory resistance for detecting and monitoring VCD complicated by asthma.

Acknowledgements

No funding was received for the preparation of this case report.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

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