The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

HYPOTONIC TRACHEO-BRONCHIAL DYSKINESIA: A NEW LOOK AT AN UNCOMMON RESPIRATORY DISORDER.

Enrico M. Melillo, M.D., *Giuseppe Belfiore, M.D., Giovanni Balzano, M.D., *Giorgio Chef, M.D., Emilio De Angelis, M.D. - Division of Pneumology and Asthma Center, Rehabilitation Institute of Campoli M.T. (BN), Foundation "S. Maugeri", IRCCS, Italy; *Dept. of Radiology, National Research Council, University "Federico II", Naples, Italy

Hypotonic tracheo-bronchial dyskinesia (HTBD) is a rather uncommon (underestimated ?) disorder: only few cases have been reported in recent literature. We evaluated four cases of HTBD through functional (flow-volume curve), endoscopic (FBS) and computed tomographic (CT) examination. Symptoms of HTBD are non specific, resulting from impaired ventilatory mechanism and ineffective cough: variable degree of breathlessness, dyspnoea, expiratory wheeze, persistent or abnormal cough, worsening of a baseline disease. By a functional point of view, a flow-volume loop with signs of variable intrathoracic obstruction may suggest the diagnostic hypothesis of HTBD. The expiratory loop is abnormal on the highest point of peak flow: a flattering of PEF occurs while the rest of the loop may be almost normal. Finally, some functional aspects deserve to be pointed out: 1) no modification occurs in the flow-volume loop after inhalation of ß_{2}-agonists; 2) normal FEV_{1} and FVC may be observed even if the maximal expiratory loop is reduced. HRCT and/or multiplanar electronic reconstruction confirmed our bronchoscopic findings and proved to be useful for the diagnosis of HTBD.

Key Words: hypotonic tracheobronchial dyskinesia-intrathoracic obstruction-high resolution computed tomography.

HTBD, hypotonic tracheobronchial dyskinesia; FBS, fiberoptic bronchoscopy; HRCT, high resolution computed tomography; PEF, peak expiratory flow; FEV_{1}, forced expiratory volume in 1 sec.; FVC, forced vital capacity.

OF-97-088

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