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Paradoxical Vocal Fold Movement: A Retrospective Analysis
Journal article

Paradoxical Vocal Fold Movement: A Retrospective Analysis

Dylan Vance, Cameron Heyd, Matthew Pier, Ghiath Alnouri and Robert T. Sataloff
Journal of voice, v 35(6), pp 927-929
01 Nov 2021
PMID: 32418667

Abstract

Audiology & Speech-Language Pathology Life Sciences & Biomedicine Otorhinolaryngology Science & Technology
Background. Paradoxical vocal fold motion (PVFM) is a disorder in which the vocal folds adduct inappropriately during inspiration resulting in episodic dyspnea and sometimes respiratory distress. Diagnosis is obtained through careful history, physical examination, flexible laryngoscopic examination with provocative maneuvers, and laryngeal electromyography. The pathogenesis and clinical findings of this disorder are not known. Objectives. To determine characteristics of patients with confirmed PVFM and to evaluate efficacy of current treatments. Methods. A retrospective chart review of the patients with PVFM who presented at a quaternary care laryngol-ogy office between January 1, 2007 and August 31, 2019 was performed. Comorbidities, laboratories tests, imag-ing, 24-hours pH impedance testing, and laryngeal EMG results were analyzed. Dyspnea Index questionnaire before and after treatment was used to evaluate the efficiency of treatments for PVFM. Results. The average age of the 40 patients was 30.25 years. Forty-five percent of patients were under the age of 18, and 80% were female. Twenty-five percent of patients were serious athletes, and 40% of patients were stu-dents. Sixty-five percent had a previous diagnosis of asthma. One third of patients had concurrent psychiatric diagnosis. There was no family history of PVFM in the cohort. There were no other common findings. Treatment for laryngopharyngeal reflux (LPR) was used only when there was evidence of LPR; and 93% of our 40 patients received LPR treatment. Ninety percent of patients who received botulinum toxin, voice therapy (VT), and LPR treatment had subjective improvement. Patients with just VT and LPR treatment had a 43% subjective improve-ment rate; and the difference was statistically significant at P of 0.021. There was no statistical difference between VT and LPR treatment versus VT or LPR treatment alone. Conclusion. Botulinum toxin, VT, and LPR treatment regimen is currently the most effective management for patients with paradoxical vocal fold movement disorder. More research is needed to determine the etiology of this disorder.

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Collaboration types
Domestic collaboration
Web of Science research areas
Audiology & Speech-language Pathology
Otorhinolaryngology
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