Horsesness and coughing

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Dawn, Judy and all Please read this section From Dr. Trenthams report.

For his full text you can find it at www.rpolychondritis.tripod.com/DRTham.html

Hoarseness, signifying laryngotracheal inflammation, is likely to develop during the course of the disease. It can progress to complete aphonia and may be associated with tenderness and swelling over the thyroid cartilage and anterior trachea. Other symptoms of laryngotracheal involvement include cough, dyspnea, wheezing, and choking. Involvement of the airway may be localized or diffuse. The larynx and upper trachea are affected most frequently (16). In severe cases, inflammatory edema can cause acute airway narrowing. Persistent inflammation can destroy the cartilaginous rings and create luminal collapse. Obstruction may also be induced iatrogenically by bronchoscopy, intubation, or tracheostomy (17). Bronchial cartilage inflammation may lead to diffuse narrowing of the lower airway and can impair mucociliary functions. Both factors predispose to recurrent lower respiratory tract infections. Pulmonary parenchymal involvement is not characteristic of relapsing polychondritis.

Conventional radiography and computed tomography identify laryngotracheal lesions (16), and thinsection computed tomography defines abnormalities in lobar and segmental bronchi (18). Three-dimensional or spiral magnetic resonance imaging may provide better resolution. The nature of airway obstruction, whether fixed or dynamic, and the location, whether intra or extrathoracic, can be assessed by pulmonary function tests, especially flow volume loops (19). Pulmonary function tests are useful tools for monitoring change over time. In addition, computed tomography and pulmonary function tests may detect otherwise asymptomatic lower airway disease (2, 19). Bronchoscopy may also be informative but carries a risk for exacerbating airway inflammation (20). Intubation for any reason may be difficult because of a small glottis caused by edema or cartilage destruction (21). In patients without laryngeal involvement, trauma at the time of endotracheal tube insertion may incite localized disease (22).

Hope this helps.

Love R.