A case of functional upper airway obstruction due to vocal cord dysfunction

Functional upper airway obstruction due to vocal cord dysfunction is being increasingly recognized and has been variously described as 'Munchausen's stridor', 'Emotional laryngeal wheezing', 'Nervous asthma'. It's features are symptoms of acute reversible recurrent dyspnea associated with an inspiratory stridor, normal anatomy of the upper airway, demonstration of variable severe extrathoracic upper airways obstruction with pathologic adduction of the vocal cord at bronchoscopy. The patients with this condition are frequently misdiagnosed as asthma and the diagnosis is often delayed. So they can present a serious medical problem and are exposed to the complication of treatment and investigation. We report a case of functional upper airway obstruction due to vocal cord dysfunction who showed paradoxical vocal cord motion at bronchoscopy and typical features of variable extrathoracic obstruction on Flow-volume loop during a symptomatic period.