Abstract
A 15-yr-old male, known to have bronchial asthma and hyperventilation syndrome, developed acute inspiratory stridor. Spirometry indicated extrathoracic airway obstruction, and a bronchofiberoptic examination disclosed narrowing in the hypopharynx with an abnormally shaped epiglottis which trembled on the inspiratory phase, but no abnormality in vocal cord or trachea. The stridor attack did not respond to the treatment such as inhalation of adrenergic agonists, anticholinergic agents and steroid, gurgling with atropine sulfate or xylocaine, and aminophylline or steroid injection. After administration of sedatives, the stridor suddenly disappeared. Psychotherapy decreased occurrence of subsequent stridor attack. It is suggested that psychogenic laryngo-pharyngeal spasm may be causative of upper airway obstruction with respiratory distress.
