A 63 year old woman presented with a 3 year history of exertional dysp
noea. Spirometry suggested extrathoracic airway obstruction (decreased
inspiratory flow and saw-tooth pattern of flow-volume curves), and br
onchoscopy revealed structural lesions and a trembling motion in the a
rytenoid region, causing upper airway obstruction on forced respirator
y efforts. As there were no abnormal findings other than the lesions,
the exertional dyspnoea was probably caused by impaired movement of th
e arytenoid region.