The Manchester Airways Service investigates and treat patients with breathlessness thought to be caused by problems in the throat and upper chest, or by a disturbance of the normal breathing pattern. The service is run by Dr Stephen Fowler (Respiratory Physician) and Jemma Haines (Consultant Speech and Language Therapist).
The most common conditions we look for are called Inducible Laryngeal Obstruction and Breathing Pattern Disorder. Often patients have other medical problems that co-exist and contribute to their symptoms, especially lung conditions such as asthma.
Inducible Laryngeal Obstruction
Upper airway dysfunction can be due to an intermittent restriction at the top of the airway in the voice box (larynx). Restriction in the larynx can be due to obstruction at the level of the vocal cords, or above, and causes shortness of breath which can be very severe. This condition is called Inducible Laryngeal Obstruction (ILO), also known as vocal cord dysfunction (VCD). It typically occurs when breathing in, but can also happen during breathing out. It usually comes on suddenly when exposed to a trigger (like a strong smell or change in temperature). It typically improves within a few minutes but can sometimes take much longer.
Breathing Pattern Disorder
Restriction in breathing can also be due to having a breathing pattern disorder. This is where there is an alteration to how you breathe, for example using the wrong muscles to breath or breathing too fast. This can lead to symptoms including breathlessness which is out of proportion to the activity you are doing and a specialist physiotherapy assessment is required, following which you may be offered further physiotherapy treatment to help improve your breathing pattern.
ILO and breathing pattern disorder are very common in patients with severe asthma and this makes diagnosis and treatment challenging. The Manchester Airways Service works in parallel with the Severe Asthma Team at Wythenshawe hospital and many patients are cared for by both teams.
Our service provides a tertiary level service, meaning patients are referred to us from both GPs and hospital consultants, regionally and nationally. There are currently only five similar services in the United Kingdom.
We provide assessment, treatment, support and advice to patients suspected of having problems such as Inducible Laryngeal Obstruction and Breathing Pattern Disorder. All new patients are given a ‘one stop’ treatment appointment where a full clinical history and initial investigations are completed on the same day. Prior to an individual’s appointment we try to transfer as many previous test/investigation results that may have happened previously to ensure that we have as much information as possible is available and that no tests are repeated unnecessarily.
Once a diagnosis is made patients are offered appropriate treatment. If this includes speech and language therapy, and patients are travelling long distances, then appointments may be offered over the internet via SkypeTM. A clinical psychology assessment may also be discussed with you as we understand that some patients can struggle with the emotional burden of such diagnoses.
We have close links with our other respiratory colleagues both regionally and nationally through multi-disciplinary team meetings (MDT), which ensure we provide the best patient care.
The team includes Medical Physicians, Speech and Language Therapists, a Clinical Nurse Specialist, a Respiratory Physiotherapist and a Clinical Psychologist. As this is a University Teaching Hospital there may also be medical students and other health professionals in training present during clinic visits.
Tests and Treatment
A wide range of tests are available to ensure that a thorough assessment can be made. These may include;
- specialist breathing tests
- chest x-ray
- blood tests
- allergy tests
- sputum testing
- CT scan
- Provocation laryngoscopy
Manchester Airways Service is one of the UKs leading centres for research into breathlessness caused by upper airway problems, and have a wide range of research projects ongoing. We recruit volunteers to the national Large Airway Registry, in which we collect information on these poorly recognised conditions with the aim of improving future care.
You can be referred by your GP or local Respiratory Physician to the Manchester Airways Service.
Phone: 0161 291 4245 (secretary)
The Manchester Airways Service is based at the North West Lung Centre, Wythenshawe Hospital, in the Yellow Zone, through entrance 5.