A 63-year-old woman presented with a chief complaint of episodic "attacks" characterized by dyspnea and wheezing. A flow-volume loop suggested variable extrathoracic airway obstruction. We saw signs of nearly complete tracheal obstruction during flexible bronchoscopy, but surprisingly, rigid bronchoscopy under general anesthesia failed to identify an anatomic abnormality. Airways resistance was normal. A discrepancy between inspiratory airflow and airways resistance noninvasively provides evidence of nonorganic upper airway obstruction.
