Functional upper airway obstruction. A new syndrome.

Functional airway obstruction is an uncommon condition that must be considered in adults with apparent airway distress. The disorder is characterized by stridor without abnormal physical findings on laryngeal examination other than intense vocal cord adduction. Three patients had functional upper airway obstruction documented by objective criteria. In each case the respiratory embarrassment was severe enough to warrant tracheostomy. A thorough search for systemic causes did not reveal an organic etiologic factor. Psychiatric evaluation demonstrated psychological disorders in each case. Functional airway obstruction represents an important consideration in the differential diagnosis of airway obstruction in the adult.