Biphasic flow volume curve due to obstruction of main bronchus by bronchogenic cyst

Mazzei, Juan Antonio; Barro, Analía; Mazzei, Mariano E.; Portas, Tamara; Esteva, Hugo

doi:10.1016/j.rmedc.2011.01.005

Cited by 7 publications

(12 citation statements)

References 15 publications

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“…This is the first study to focus primarily on the clinical and physiological relevance of changes in the shape of the F-V curve in patients according to the degree of unilateral main bronchial stenosis. Unilateral bronchial stenosis is a very rare disorder; few case reports have correlated the shape of the F-V curve with unilateral main bronchial stenosis [ 7 , 8 , 9 , 12 , 17 ]. The American Thoracic Society/European Respiratory Society statement (2005) of interpretative strategies for the lung function test did not recommend a typical pattern for the F-V curve in cases of a unilateral main bronchial stenosis, whereas the plateau pattern of the F-V curve is useful for diagnosis in cases of tracheal stenosis [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…We analyzed F-V curves performed during the week before bronchoscopy and chest CT. A biphasic F-V curve was defined as having two distinct plateau phases. A monophasic F-V curve was defined as having only one plateau phase [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. In addition, the breakpoint of the F-V curve was defined as the meeting point of the different plateau phases.…”

Section: Methodsmentioning

confidence: 99%

“…In 1990, Gascoigne et al [ 7 ] first described the biphasic change in the expiratory phase of the F-V curve in two patients with unilateral main bronchial stenosis. After the first case report, several case reports and studies over the next 20 years identified a biphasic F-V curve pattern in patients with a unilateral main bronchial stenosis [ 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Changes in the Flow-Volume Curve According to the Degree of Stenosis in Patients With Unilateral Main Bronchial Stenosis

Yoo

et al. 2015

Clin Exp Otorhinolaryngol

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ObjectivesThe shape of the flow-volume (F-V) curve is known to change to showing a prominent plateau as stenosis progresses in patients with tracheal stenosis. However, no study has evaluated changes in the F-V curve according to the degree of bronchial stenosis in patients with unilateral main bronchial stenosis.MethodsWe performed an analysis of F-V curves in 29 patients with unilateral bronchial stenosis with the aid of a graphic digitizer between January 2005 and December 2011.ResultsThe primary diseases causing unilateral main bronchial stenosis were endobronchial tuberculosis (86%), followed by benign bronchial tumor (10%), and carcinoid (3%). All unilateral main bronchial stenoses were classified into one of five grades (I, ≤25%; II, 26%-50%; III, 51%-75%; IV, 76%-90%; V, >90% to near-complete obstruction without ipsilateral lung collapse). A monophasic F-V curve was observed in patients with grade I stenosis and biphasic curves were observed for grade II-IV stenosis. Both monophasic (81%) and biphasic shapes (18%) were observed in grade V stenosis. After standardization of the biphasic shape of the F-V curve, the breakpoints of the biphasic curve moved in the direction of high volume (x-axis) and low flow (y-axis) according to the progression of stenosis.ConclusionIn unilateral bronchial stenosis, a biphasic F-V curve appeared when bronchial stenosis was >25% and disappeared when obstruction was near complete. In addition, the breakpoint moved in the direction of high volume and low flow with the progression of stenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in the Flow-Volume Curve According to the Degree of Stenosis in Patients With Unilateral Main Bronchial Stenosis

Yoo

et al. 2015

Clin Exp Otorhinolaryngol

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“…Finally, the restrictive pattern on lung function testing, shown by our first three patients, has been observed in several cases of fixed unilateral main stem bronchial stenosis due to extrinsic compression or intrinsic obstruction . Moreover, the biphasic configuration of the inspiratory arm of the flow‐volume loop during a forced inspiration, shown in our third patient, is compatible with unilateral obstruction of a main bronchus . In this condition, during a forced inspiration, the MIFV curve shows a marked slowing of the flow toward the end of inspiration, when the partial release of the bronchial compression induced by the fast expansion of the lung runs out.…”

Section: Discussionmentioning

confidence: 99%

“…On admission, pulmonary function tests demonstrated a mixed moderate‐severe ventilatory defect (FVC = 77% and FEV 1 = 53% of predicted). However, when the patient performed a forced inspiration, the inspiratory arm of the flow‐volume loop showed a biphasic configuration (arrow), consistent with the presence of a unilateral compression of one main bronchus (Fig. A).…”

Section: Case Reportsmentioning

confidence: 99%

Short-length ligamentum arteriosum as a cause of congenital narrowing of the left main stem bronchus

et al. 2016

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An entity that has received little attention as cause or recurrent respiratory disorder is the narrowing of the left main stem bronchus. When not associated with congenital heart disorders, this condition has been ascribed to primary localized malacia of the bronchial cartilages or to the anterior displacement of the descending aorta in front to the adjacent vertebral bodies. Four girls were evaluated for recurrent/chronic respiratory symptoms. A pulsatile extrinsic compression on the posterior bronchial wall of the left main stem bronchus was detected, pressed between the descending aorta, posteriorly, and the left pulmonary artery, anteriorly. The two arteries were closely linked together by a short-length ligamentum that was resected, allowing the mobilization of the aorta with posterior aortopexy, stabilizing the space created between the pulmonary artery and the descending aorta. The reduced compression on the left main bronchus resulted in the enlargement of its caliber and in a marked improvement of the respiratory symptoms. Pediatr Pulmonol. 2016;51:1356-1361. © 2016 Wiley Periodicals, Inc.

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Flow-volume loop abnormality detecting a previously unrecognized right upper lobe tracheal bronchus

Ruzycki

Tsai

Davidson

2015

Respiratory Medicine Case Reports

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Tracheal bronchus is a rare anatomic variant in which a bronchus originates from the trachea. Patients may be asymptomatic or present with a variety of respiratory symptoms. We present a case of a patient who presented with a history of poorly controlled asthma and a persistent abnormality of the flow-volume loop. Bronchoscopy revealed a tracheal bronchus with narrowed right-sided bronchial orifices. An unrecognized tracheal bronchus may result in serious complications during elective or emergent endotracheal intubation. Spirometry testing may reveal abnormalities of the flow-volume loop associated with altered airflow. Relying on spirometric values without assessing the shape of the flow-volume loop may lead to misdiagnosis and inappropriate management of lung pathology.

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Biphasic flow volume curve due to obstruction of main bronchus by bronchogenic cyst

Cited by 7 publications

References 15 publications

Changes in the Flow-Volume Curve According to the Degree of Stenosis in Patients With Unilateral Main Bronchial Stenosis

Changes in the Flow-Volume Curve According to the Degree of Stenosis in Patients With Unilateral Main Bronchial Stenosis

Short-length ligamentum arteriosum as a cause of congenital narrowing of the left main stem bronchus

Flow-volume loop abnormality detecting a previously unrecognized right upper lobe tracheal bronchus

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