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Paradoxical vocal fold dysfunction

Virginie Woisard, Xuelai Liu, Marie Christine Arné Bes, Marion Simonetta-Moreau
Data, regarding the use of botulinum toxin (BT-A) in laryngeal dyspnea, are scarce, coming from some cases reports in the literature, including Vocal fold paralysis, laryngeal dystonia, vocal cord dysfunction also called paradoxical motion of the vocal fold (PMVF), and post-neuroleptic laryngeal dyskinesia. There is no consensus regarding the muscles and the doses to inject. The aim of this study is to present a retrospective review of patients treated in our ENT Department by BT-A injection in this indication...
September 6, 2016: European Archives of Oto-rhino-laryngology
Nizhoni Denipah, Christopher M Dominguez, Erik P Kraai, Tania L Kraai, Paul Leos, Darren Braude
Paradoxical vocal fold motion disorder, also commonly termed vocal cord dysfunction, is a poorly understood cause of acute upper airway obstruction. Patients with paradoxical vocal fold motion frequently present to the emergency department (ED) with acute respiratory distress and stridor. Lack of familiarity with this disorder may lead to delayed diagnosis or misdiagnosis and unnecessary intubations or surgical airway procedures. Although long-term management of paradoxical vocal fold motion is well described, there is a paucity of information about acute evaluation and management...
August 10, 2016: Annals of Emergency Medicine
Julie Depiazzi, Mark L Everard
Excessive exercise-induced shortness of breath is a common complaint. For some, exercise-induced bronchoconstriction is the primary cause and for a small minority there may be an alternative organic pathology. However for many, the cause will be simply reaching their physiological limit or be due to a functional form of dysfunctional breathing, neither of which require drug therapy.The physiological limit category includes deconditioned individuals, such as those who have been through intensive care and require rehabilitation, as well as the unfit and the fit competitive athlete who has reached their limit with both of these latter groups requiring explanation and advice...
June 2016: Breathe
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
Loveleen Guglani, Sarah Atkinson, Avinash Hosanagar, Lokesh Guglani
BACKGROUND: Vocal cord dysfunction (VCD) or paradoxical vocal-fold motion (PVFM) is a functional disorder of the vocal cords that requires multidisciplinary treatment. Besides relaxation techniques, the use of psychological interventions can help treat the underlying psychological co-morbidities. There is currently no literature that examines the effectiveness of psychological interventions for VCD/PVFM. OBJECTIVES: To review the evidence for psychological interventions used for the treatment of patients with VCD/PVFM...
2014: Frontiers in Pediatrics
Douglas R Sidell, Karthik Balakrishnan, Catherine K Hart, J Paul Willging, Sandra K Knecht, Alessandro de Alarcon
OBJECTIVE: Exercise-induced airway obstruction in pediatric patients is a unique phenomenon with multiple potential etiologies. An accurate diagnosis can be challenging to establish in pediatric patients because they are frequently asymptomatic at rest. Exercise stress laryngoscopy (ESL) is a modality by which pediatric patients can be evaluated under physiologic conditions that produce their symptoms. The purpose of this study was to demonstrate (1) the diagnostic effectiveness of pediatric ESL and (2) the ability of ESL to guide treatment for "normal" and post-airway reconstruction patients with exercise intolerance...
June 2014: Otolaryngology—Head and Neck Surgery
Justin C McCarty, Berrylin J Ferguson
Asthma has many triggers including rhinosinusitis; allergy; irritants; medications (aspirin in aspirin-exacerbated respiratory disease); and obesity. Paradoxic vocal fold dysfunction mimics asthma and may be present along with asthma. This article reviews each of these triggers, outlining methods of recognizing the trigger and then its management. In many patients more than one trigger may be present. Full appreciation of the complexity of these relationships and targeted therapy to the trigger is needed to best care for the patient with asthma...
February 2014: Otolaryngologic Clinics of North America
Celso Eduardo Olivier, Daiana Guedes Pinto Argentão, Regiane Patussi dos Santos Lima, Mariana Dias da Silva, Raquel Acácia Pereira Gonçalves dos Santos
Vocal cord dysfunction (also called paradoxical vocal cord motion) or paradoxical vocal fold motion (PVFM) is an event elicited by specific and nonspecific triggers in which its diagnosis is limited by the restricted number of available functional tests. This study was designed to appreciate the contribution of the spirometric changes elicited by the allergen-specific nasal provocation test (NPT) performed with Dermatophagoides pteronyssinus for the diagnosis of PVFM in subjects with known sensitization to this allergen...
September 2013: Allergy and Asthma Proceedings:
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
Sally J K Gallena, Wei Tian, Arthur T Johnson, Jafar Vossoughi, Stephen A Sarles, Nancy Pearl Solomon
OBJECTIVE: To determine the correlation between respiratory resistance (Rr) values measured with the Airflow Perturbation Device (APD) to laryngoscopic images of glottal area (GA) in feigned paradoxical vocal fold motion (PVFM), also known as vocal cord dysfunction. HYPOTHESIS: There is a strong inverse relationship between Rr and GA such that laryngeal constriction can be detected and quantified by APD-measured Rr. STUDY DESIGN: Prospective, single subject study...
May 2013: Journal of Voice: Official Journal of the Voice Foundation
Ron Balkissoon, Klaus Kenn
Vocal cord dysfunction (VCD) and dysfunctional breathing (DB) disorders may mimic or coexist with asthma, leading to overtreatment with corticosteroids with consequent morbidity. Iatrogenic complications can be averted by early and correct diagnosis. VCD, also termed paradoxical vocal fold motion disorder (PVFMD), is characterized by intermittent paradoxical adduction of the vocal cords, mainly during inspiration, leading to airflow obstruction and dyspnea. Patients with VCD may have repetitive emergency room visits due to acute dyspnea (mimicking exacerbations of asthma)...
December 2012: Seminars in Respiratory and Critical Care Medicine
Ali Al-Alwan, David Kaminsky
Vocal cord dysfunction (VCD) is a syndrome characterized by the intermittent, abnormal paradoxical adduction of the true vocal cords during respiration resulting in variable upper airway obstruction. It is also commonly referred to as paradoxical vocal fold motion disorder. Patients with VCD usually present with intermittent shortness of breath of varying intensity, wheezing, stridor, choking, throat tightness, voice changes, or cough, and these symptoms often resolve quickly after relaxation or cessation of activity...
May 2012: Physician and Sportsmedicine
L Arick Forrest, Tiffany Husein, Omar Husein
Paradoxical vocal cord motion (PVCM), or vocal cord dysfunction, is a descriptive term for inappropriate adduction of the vocal folds during respiration. The laryngeal mistiming leads to breathing difficulty and is often misdiagnosed as refractory asthma. The etiology of PVCM has been unclear but has long been hypothesized to be psychological. The present thesis is a prospective study of 170 patients older than 18 years being evaluated for PVCM, with 117 of the 170 (68.8%) identified as having PVCM by video laryngoscopy...
April 2012: Laryngoscope
Andrea Nacci, Bruno Fattori, Giovanni Segnini, Iacopo Dallan, Erica Panicucci, Valeria Rocchi, Francesco Ursino
OBJECTIVES: Paradoxical vocal fold dysfunction (PVFD) is a disorder in the larynx featuring involuntary adduction of the vocal folds during the inspiratory phase of breathing. The symptoms include acute episodes of dyspnea and bouts of coughing. To date, there is no universally acknowledged treatment for PVFD, though respiratory retraining therapy is the treatment of choice. AIMS: The purpose of this work was to evaluate the results of long-term respiratory retraining therapy in cases of PVFD...
2011: Folia Phoniatrica et Logopaedica
Anne E Vertigan, Peter G Gibson, Deborah G Theodoros, Alison L Winkworth
Sensory function may be important in the pathogenesis of Chronic Cough (CC) and Paradoxical Vocal Fold Movement (PVFM). This paper aims to explore sensory issues related to the pathogenesis, classification, assessment and management of these conditions. Sensory disruption of the vagus nerve can occur through neural plasticity whereby a change occurs in the way a central neuron reacts to an incoming stimulus. Such disruption can be demonstrated through assessment of cough reflex sensitivity and extrathoracic airway hyperresponsiveness both of which may be increased in CC and PVFM...
2008: International Journal of Speech-language Pathology
C Walaschek, J Forster, M Echternach
Vocal cord dysfunction (VCD) is an important differential diagnosis in acute dyspnoea. VCD is caused by adduction of the vocal folds during respiration typically leading to attacks of dyspnoea, stridor and coughing. Here we present an extraordinary case of an untypical paradoxical vocal fold adduction in a 15-year-old girl with stridor persisting over several weeks.
March 2010: Klinische Pädiatrie
Kent L Christopher, Michael J Morris
This article presents disorders of periodic occurrence of laryngeal obstruction (POLO) resulting in noisy breathing and dyspnea and a variety of secondary symptoms. Included in this classification are glottic disorders, such as paradoxic vocal fold movement and vocal cord dysfunction. The supraglottic disorder, termed, intermittent arytenoid region prolapse or laryngomalacia, is also reviewed. Three categories of POLO are defined as irritant, exertional, and psychological.
February 2010: Otolaryngologic Clinics of North America
Kursat Yelken, Erdogan Gultekin, Mehmet Guven, Ahmet Eyibilen, Ibrahim Aladag
OBJECTIVES/HYPOTHESIS: To compare subjective and objective voice-quality parameters between asymptomatic paradoxical vocal fold motion dysfunction (PVFMD) patients and healthy individuals. STUDY DESIGN: Prospective. METHODS: A total number of 12 patients with PVFMD and 12 healthy control subjects had voice evaluations by means of laryngostroboscopy, acoustic analysis (jitter, shimmer, and harmonics-to-noise ratio [HNR]), aerodynamic measurements (maximum phonation time [MPT], s/z ratio), and perceptual analysis (Grade, Roughness, Breathiness, Asthenicity, and Strain Scale [GRBAS] and Voice Handicap Index-10 [VHI-10] scales)...
November 2010: Journal of Voice: Official Journal of the Voice Foundation
Joyce Gurevich-Uvena, Joseph M Parker, Thomas M Fitzpatrick, Matthew J Makashay, Michelle M Perello, Elizabeth A Blair, Nancy Pearl Solomon
OBJECTIVES/HYPOTHESES: This study aimed to describe the demographic characteristics of patients diagnosed with paradoxical vocal fold motion (PVFM) at Walter Reed Army Medical Center (WRAMC), and to document common medical comorbidities. The military population was expected to differ from the general population because of a presumed association between high physical demands and PVFM. STUDY DESIGN: Retrospective chart review of active-duty (AD) military personnel compared with a natural control group of non-AD patients...
November 2010: Journal of Voice: Official Journal of the Voice Foundation
Kursat Yelken, Ayse Yilmaz, Mehmet Guven, Ahmet Eyibilen, Ibrahim Aladag
BACKGROUND AND OBJECTIVE: Paradoxical vocal fold motion dysfunction (PVFMD) is a disorder of the larynx characterized by adduction of the vocal cords during the respiratory cycle leading to symptoms of extrathoracic airway obstruction. PVFMD mimics asthma and patients with PVFMD (PVFMD+) are often diagnosed incorrectly as refractory asthma and receive unnecessary treatment. This study determined the prevalence of PVFMD in asthma patients and described the relationship between asthma and PVFMD...
July 2009: Respirology: Official Journal of the Asian Pacific Society of Respirology
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