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Paradoxical vocal fold movement

Anne E Vertigan, Sarah M Kapela, Emily K Kearney, Peter G Gibson
BACKGROUND: Chronic refractory cough(CRC), a phenotype of Cough Hypersensitivity Syndrome(CHS), is a disabling problem. Laryngeal dysfunction may be important in CC and CHS because laryngeal symptoms are common and CC, however the role of laryngeal dysfunction in CHS has not been systematically examined. OBJECTIVE: To determine the nature of laryngeal dysfunction in patients with CC and compare with the related laryngeal conditions of Vocal Cord Dysfunction(VCD) and Muscle Tension Dysphonia(MTD)...
May 2, 2018: Journal of Allergy and Clinical Immunology in Practice
Ahmed Geneid, L-M Aaltonen, L Porra, J Peltonen, K Palmu, A Sovijärvi, P Piirilä
The objective of this study was to evaluate associations between the breathing sound spectra and glottal dimensions in exercise-induced vocal cord dysfunction (EIVCD) during a bicycle ergometry test. Nineteen subjects (mean age 21.8 years and range 13-39 years) with suspected EIVCD were studied. Vocal folds were continuously imaged with videolaryngoscopy and breathing sounds were recorded during the bicycle exercise test. Twelve subjects showed paradoxical movement of the vocal folds during inspiration by the end of the exercise...
November 2017: European Archives of Oto-rhino-laryngology
Tian-Tee Ng
Paradoxical Vocal Fold Movement Disorder is where the larynx exhibits paradoxical vocal cords closure during respiration, creating partial airway obstruction. Causes of vocal fold movement disorder are multifactorial, and patients describe tightness of throat, difficulty getting air in, have stridor, and do not respond to inhalers. We propose using transnasal laryngoscopy examination, which will show narrowing of vocal cords on inspiration, and The Pittsburgh Vocal Cord Dysfunction Index with a cutoff score of ≥4 to distinguish vocal fold movement disorder from asthma and other causes of stridor...
2017: Open Access Emergency Medicine: OAEM
Scott Kramer, Brad deSilva, L Arick Forrest, Laura Matrka
OBJECTIVES/HYPOTHESIS: To determine whether diagnosis and treatment of paradoxical vocal fold movement disorder (PVFMD) leads to decreased asthma medication use. Secondary objectives include determining initial rate of asthma medication use, characterizing symptom improvement, and correlating with pulmonary function testing (PFT). STUDY DESIGN: Prospective observational study. METHODS: Patients newly diagnosed with PVFMD at a single institution were recruited to participate...
July 2017: Laryngoscope
Jinny Ye, Mehdi Nouraie, Fernando Holguin, Amanda I Gillespie
OBJECTIVES: Goals of the current study were to (1) conduct initial validation of a new Paradoxical Vocal Fold Movement Disorder Screening Questionnaire (PVFMD-SQ); (2) determine if symptom-based questionnaires can discriminate between patients with confirmed PVFMD and those with diagnosed uncontrolled asthma without clinical suspicion for PVFMD; and (3) determine if a new questionnaire with diagnostic specificity could be created from a combination of significant items on previously validated questionnaires...
May 2017: Journal of Voice: Official Journal of the Voice Foundation
Liuba Soldatova, Candace Hrelec, Laura Matrka
OBJECTIVE: To determine if the results of routine spirometry and flow volume loops (Pulmonary Function Tests (PFTs)) can be used to distinguish Paradoxic Vocal Fold Movement Disorder (PVFMD) from Subglottic Stenosis (SGS). METHODS: PFT records and medical history of 49 patients with diagnosis of PVFMD and 39 patients with SGS were compared. Groups were then subdivided to compare PFTs in patients with and without smoking history or lung disease. RESULTS: Peak expiratory flow rate (PEFR) and Expiratory Disproportion Index (ratio of forced expiratory volume in 1 second (FEV1) over PEFR (FEV1/PEFR)) were both significantly different between patients with SGS and those with PVFMD (p<0...
December 2016: Annals of Otology, Rhinology, and Laryngology
Yeun Hee Shin, Keu La Me Song, Dong Chan Ko, Jung Woo Pin, Kyong Ho Ryu, Hyun Soo Kim
Paradoxical vocal fold movement (PVFM) is an uncommon upper airway disorder defined as paradoxical adduction of the vocal folds during inspiration. The etiology and treatment of PVFM are unclear. The physician should manage this condition because of the possibility of near complete airway obstruction in severe case of PVFM. We report a case of successful airway management in a patient with PVFM by applying continuous positive airway pressure (CPAP). In this case, PVFM was detected after removing an endotracheal tube from a 67-year-old male who underwent excision of a laryngeal mass...
February 2016: Korean Journal of Anesthesiology
Peter G Gibson, Anne E Vertigan
Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia...
December 14, 2015: BMJ: British Medical Journal
Alexandra A Shams, Jeffrey C Leggit
Paradoxical vocal fold movement is important to consider in the differential for dyspnea on exertion or shortness of breath. It is often confused with asthma and remains undiagnosed because of a paucity of pathognomonic examination and imaging findings. This case serves as a reminder of the specific clinical picture, diagnosis, and treatment of paradoxical vocal fold movement. It also highlights the broader importance of continuity of care and the clinician's ability to revisit the differential diagnosis if an initial workup is unrevealing or the patient is not responding to treatment...
October 2015: Military Medicine
Aracy Pereira Silveira Balbani
INTRODUCTION:  The cough is the more common respiratory symptom in children and adults. OBJECTIVE:  To present a revision on the neurophysiology and the methods for study of the consequence of the cough, as well as the pharmacotherapy and phonoaudiology therapy of the cough, based on the works published between 2005 and 2010 and indexed in the bases Medline, Lilacs and Library Cochrane under them to keywords "cough" or "anti-cough". Synthesis of the data: The consequence of the cough involves activation of receiving multiples becomes vacant in the aerial ways and of neural projections of the nucleus of the solitary treatment for other structures of the central nervous system...
April 2012: International Archives of Otorhinolaryngology
Asier Lekue, Isabel García-López, Susana Santiago, Antonio Del Palacio, Javier Gavilán
Laryngeal synkinesis is a vocal fold movement disorder produced by a misdirected reinnervation after a recurrent laryngeal nerve injury. Its symptoms differ greatly between patients, requiring diverse therapeutical approaches. We aim to describe our experience in the diagnosis and treatment of different laryngeal synkinesis presentations. 11 patients diagnosed between 2011 and 2014 in a tertiary referral center with laryngeal synkinesis confirmed by laryngeal electromyography were included in our study. All medical records and laryngoscopic and electromyographic data were reviewed retrospectively...
September 2015: European Archives of Oto-rhino-laryngology
James Tod Olin, Matthew S Clary, Emily H Deardorff, Kristina Johnston, Michael J Morris, Mofiyinfolu Sokoya, Herman Staudenmayer, Kent L Christopher
Exercise as an important part of life for the health and wellness of children and adults. Inducible laryngeal obstruction (ILO) is a consensus term used to describe a group of disorders previously called vocal cord dysfunction, paradoxical vocal fold motion, and numerous other terms. Exercise-ILO can impair one's ability to exercise, can be confused with asthma, leading to unnecessary prescription of asthma controller and rescue medication, and results in increased healthcare resource utilization including (rarely) emergency care...
February 2015: Physician and Sportsmedicine
Maria Claudia Franca
OBJECTIVES: The objective of this study was to contribute to the discussion of differential diagnosis in paradoxical vocal fold movement (PVFM), a disorder frequently associated with episodes of breathing difficulty and stridor. Because of analogous respiratory symptoms, PVFM is often misdiagnosed as asthma. Additional evidence suggests the association of factors such as respiratory struggle during physical exertion, digestive reflux, and respiratory allergies with PVFM, particularly in athletes and young females...
December 2014: International Journal of Pediatric Otorhinolaryngology
Kohei Nishimoto, Yoshihiko Kumai, Eiji Yumoto
OBJECTIVE: To establish a rat model with paradoxical vocal fold movement to understand the detailed etiology and physiology of laryngeal synkinesis by evaluating vocal fold movement and by electromyography. METHODS: Adult Wistar rats were used. The recurrent laryngeal nerve was transected, anastomosed, and the anastomotic portion was placed in a silicone tube. At 2, 4, and 10 weeks after the treatment (n = 30), we performed laryngoscopy and electromyography. The vocal fold movement was recorded, the hemiglottal area was measured, and the Δarea was calculated by subtracting the area during expiration from that during inhalation...
November 2014: Acta Oto-laryngologica
Karol V Canji, Slobodan M Mitrović, Vera M Beljin
INTRODUCTION: The aim of this paper was to present a rare disorder of epiglottis function as a cause of breathing disorders and a manner of dealing with this problem. CASE REPORT: A 59-year-old male patient had breathing disorders in the form of short cessations of breathing two months after a cardiac surgery. He could not tolerate even a slight physical effort. Indirect laryngoscopy and video endoscopy performed with a rigid endoscope indicated paradoxical movements of epiglottis, which closed the entrance to the larynx and caused short cessations of breathing...
July 2014: Medicinski Pregled
David Krey, Thomas Best
Breathing concerns in athletes are common and can be due to a wide variety of pathology. The most common etiologies are exercise-induced bronchoconstriction (EIB) and paradoxic vocal fold movement disorder (PVFMD). Although some patients may have both, PVFMD is often misdiagnosed as EIB, which can lead to unnecessary treatment. The history and physical exam are important to rule out life threatening pulmonary and cardiac causes as well as common conditions such as gastroesophageal reflux disease, sinusitis, and allergic etiologies...
December 2014: Current Reviews in Musculoskeletal Medicine
Laura Matrka
Paradoxical Vocal Fold Movement Disorder (PVFMD) is a cause of dyspnea that can mimic or occur alongside asthma or other pulmonary disease. Treatment with Laryngeal Control Therapy is very effective once the entity is properly diagnosed and contributing comorbidities are managed appropriately. In understanding the etiology of PVFMD, focus has broadened beyond psychiatric factors alone to include the spectrum of laryngeal irritants (laryngopharyngeal reflux, allergic and sinus disease, sicca, and possibly obstructive sleep apnea)...
February 2014: Otolaryngologic Clinics of North America
David L Zealear, Rajshri Mainthia, Yike Li, Isamu Kunibe, Akihiro Katada, Cheryl Billante, Kenichiro Nomura
OBJECTIVES/HYPOTHESIS: Previously, electrical stimulation of denervated canine laryngeal muscle was shown to promote reinnervation by native over foreign motoneurons. The goal of this study was to assess the effect of different stimulus paradigms on reinnervation quality and functional recovery. STUDY DESIGN: A prospective study of six canines over 8 to 20 months. METHODS: A clinical model of laryngeal paralysis was used, where recurrent laryngeal nerves of the animals were sectioned and ventilation compromised...
May 2014: Laryngoscope
Anne E Vertigan, Sarah L Bone, Peter G Gibson
BACKGROUND AND OBJECTIVE: Diseases associated with laryngeal dysfunction include chronic refractory cough (CRC), paradoxical vocal fold movement (PVFM), muscle tension dysphonia (MTD) and globus pharyngeus. We hypothesized the presence of a common sensory laryngeal dysfunction, the 'laryngeal hypersensitivity' syndrome, in these conditions. The aim of the study was to compare symptoms and sensory function in patients with CRC, PVFM, MTD and globus. METHODS: The 103 participants included healthy controls (n = 13) and four case groups: CRC (n = 33), PVFM (n = 28), globus pharyngeus (n = 11) and MTD (n = 18)...
August 2013: Respirology: Official Journal of the Asian Pacific Society of Respirology
Sarah Chamberlain, Rachel Garrod, Surinder S Birring
Cough suppression therapy (CST), also known as cough suppression physiotherapy and speech pathology management is a promising non-pharmacological therapeutic option for patients with refractory chronic cough. CST may consist of education, improving laryngeal hygiene and hydration, cough suppression techniques, breathing exercises and counselling. It is an out-patient therapy delivered in 2-4 sessions. There is evidence to support the efficacy of CST: a randomised controlled trial reported a significant reduction in cough symptoms and other studies have reported improved cough related quality of life, reduced cough reflex hypersensitivity and cough frequency...
October 2013: Pulmonary Pharmacology & Therapeutics
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