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Paradoxical vocal fold motion

Ashley P O'Connell Ferster, Tom Shokri, Michele Carr
IMPORTANCE: Paradoxical vocal fold motion (PVFM) is a disorder often misdiagnosed in children presenting with shortness of breath and stridor. In infants, little is known about the clinical course and best approach for treatment of PVFM. This retrospective study assesses the approach to treatment and outcomes for infants with PVFM. OBJECTIVE: To investigate the clinical course of paradoxical vocal fold motion (PVFM) in infants. DESIGN: Retrospective review...
April 2018: International Journal of Pediatric Otorhinolaryngology
Karen Drake, Andrew D Palmer, Joshua S Schindler, Stephen A Tilles
OBJECTIVE: Paradoxical vocal fold motion (PVFM) is responsive to behavioral therapy, often resulting in a remission of symptoms, but little is known about whether treatment is beneficial with regard to PVFM-associated psychological symptoms or functional limitations. The goal of the study was to identify patient perceptions of the impact of treatment for PVFM and characteristics associated with treatment outcomes. METHODS: A survey was conducted of all adults who had received at least 1 session of treatment for PVFM in our outpatient clinic over a 2-year period...
2017: Folia Phoniatrica et Logopaedica
Jennifer H Gross, Mary Bertrand, Keiko Hirose
Paradoxical vocal fold motion (PVFM) is characterized by vocal fold adduction during respiration. Benign Rolandic epilepsy (BRE) is the most common childhood epilepsy and can cause oropharyngolaryngeal or facial manifestations. A 9-year-old male presented with intermittent apnea lasting 30-60 seconds and presumed PVFM. The patient's physical and fiberoptic exam were normal. He was admitted and found to have episodes of oxygen desaturation, neck twitching, and tongue burning. An EEG revealed focal epilepsy. After starting anti-epileptic medications, he had resolution of symptoms...
November 2017: International Journal of Pediatric Otorhinolaryngology
Kristina L Johnston, Hannah Bradford, Heather Hodges, Camille M Moore, Emily Nauman, J Tod Olin
INTRODUCTION: Exercise-induced laryngeal obstruction (EILO), the condition previously known as paradoxical vocal fold motion and vocal cord dysfunction, is characterized by inappropriate glottic or supraglottic obstruction during high-intensity exercise, causing exertional dyspnea, frequently with stridor. EILO is definitively diagnosed through upper-airway visualization during a characteristic episode. Although respiratory retraining is a primary therapy for EILO, many patients report symptom persistence despite adequate performance of traditional techniques...
October 11, 2017: Journal of Voice: Official Journal of the Voice Foundation
Sarah Graham, Emily Deardorff, Kristina Johnston, J Tod Olin
Exercise-induced laryngeal obstruction (EILO) is the term for the condition previously named vocal cord dysfunction and paradoxical vocal fold motion. It is defined by glottic or supraglottic obstruction during periods of intense exercise. Not all patients respond to conventional therapy with speech-language pathology, behavioral health interventions, and treatment of contributing conditions. In this edition of Journal of Voice, the authors describe a novel series of respiratory retraining techniques, now called Olin EILOBI (EILO biphasic inspiratory) breathing techniques, specifically designed for athletes with EILO...
October 11, 2017: Journal of Voice: Official Journal of the Voice Foundation
Marlene Garcia-Neuer, Donna Marie Lynch, Kathleen Marquis, Jayme Dowdall, Mariana Castells, David Edward Sloane
Vocal cord dysfunction, also known as paradoxical vocal fold motion (PVFM), is a disorder characterized by abnormal vocal cord adduction during inspiration. PVFM is commonly misdiagnosed as asthma because of the similarity of symptoms: cough, wheezing, chest pain, and dyspnea. We present the clinical vignette of a 36-year-old woman with juvenile rheumatoid arthritis and multiple adverse drug reactions who presented with recurrent episodes of unrecognized PVFM during skin testing for drug allergy, omalizumab treatment, and tocilizumab desensitization...
January 2018: Journal of Allergy and Clinical Immunology in Practice
Pascale Amberger
The paradoxical vocal fold motion (PVFM) is a temporary total inability to breathe, which is important to rule out from other more or less important breathing difficulties encountered in asthma. Overtreatment for asthma instead of treatment for PVFM can lead to iatrogenic complications which can be averted by early and correct diagnosis. This article presents a list of symptoms and related disorders, enabling to more easily diagnose PVFM, as well as its specifics treatments and a « Block-unblock maneuver » not yet described in the literature, allowing the patient to respond to the crisis and to prevent future crises...
August 9, 2017: Revue Médicale Suisse
Kershena S Liao, Paul E Kwak, Hazel Hewitt, Sarah Hollas, Julina Ongkasuwan
OBJECTIVES: Paradoxical vocal fold motion (PVFM) consists of intermittent adduction of the vocal folds during inspiration, resulting in stridor and worsened by anxiety and stress. The purpose of this study was to assess the impact of PVFM on quality of life in our pediatric patient population. STUDY DESIGN: This is a prospective, descriptive survey study. METHODS: Thirty-nine consecutive patients (ages 12-17 years) presenting with a PVFM diagnosis for respiratory retraining sessions with speech-language pathology were recruited...
July 2017: Journal of Voice: Official Journal of the Voice Foundation
Blake Smith, Claudio Milstein, Bryan Rolfes, Samantha Anne
INTRODUCTION: Paradoxical vocal fold motion (PVFM) is a condition in which the vocal cords exhibit inappropriate inspiratory adduction, and it has been poorly studied in the pediatric population. METHODS: Pediatric patients diagnosed with PVCM by a pediatric otolaryngologist and doctor of speech pathology from 2008 to 2012 were reviewed. Patients in whom another cause for their respiratory disturbance was eventually identified were excluded. Patient demographics, characteristics, treatment, and outcomes were reviewed...
March 2017: American Journal of Otolaryngology
Anne Hseu, Mykayla Sandler, Dawn Ericson, Nohamin Ayele, Kosuke Kawai, Roger Nuss
INTRODUCTION: Although dyspnea with exercise in the pediatric population can be multifactorial, the diagnosis of paradoxical vocal fold motion disorder (PVFMD) in this group is not well characterized. The objective of this study is to review the multiple causes of dyspnea with exercise in children, including the prevalence of PVFMD within this study population. METHODS: A retrospective review was conducted of patients seen at a tertiary pediatric hospital for exercise-induced dyspnea suspected to be related to PVFMD between January 2007 and July 2015...
November 2016: International Journal of Pediatric Otorhinolaryngology
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...
February 2017: 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...
January 2017: 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
Naomi A Hartley, Brian E Petty, Bethany Johnson, Susan L Thibeault
BACKGROUND: Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis...
December 2015: Respiratory Medicine
Anna M Marcinow, Jennifer Thompson, L Arick Forrest, Brad W deSilva
OBJECTIVES: To review our experience with the diagnosis and treatment of irritant-induced paradoxical vocal fold motion disorder (IPVFMD). STUDY DESIGN: Retrospective chart review. SETTING: Tertiary academic referral center. SUBJECTS AND METHODS: Thirty-four cases that met IPVFMD criteria and 76 cases of non-IPVFMD were selected from a database of patients with paradoxical vocal fold motion disorder-the diagnosis of which was made on the basis of flexible fiberoptic laryngoscopy and augmented by an odor challenge...
December 2015: Otolaryngology—Head and Neck Surgery
José Montojo, Ramón González, Estefanía Hernández, Miguel Zafra, Guillermo Plaza
We describe the case of a 13-year-old girl with paradoxical vocal fold motion (PVFM) who failed to improve with repeated medical treatment, speech therapy and psychotherapy, but was successfully treated with botulinum toxin A (BTX-A) injection to the vocal folds. For delivering the BTX-A we used a channeled fiber-optic laryngoscope under local anesthesia, in an office setting. The patient remained asymptomatic of PVFM for 5 months, was successfully treated again with the same method, and had no important side effects...
July 2015: International Journal of Pediatric Otorhinolaryngology
Sally J K Gallena, Nancy Pearl Solomon, Arthur T Johnson, Jafar Vossoughi, Wei Tian
PURPOSE: An investigational, portable instrument was used to assess inspiratory (R(i)) and expiratory (R(e)) resistances during resting tidal breathing (RTB), postexercise breathing (PEB), and recovery breathing (RB) in athletes with and without paradoxical vocal fold motion disorder (PVFMD). METHOD: Prospective, controlled, repeated measures within-subject and between-groups design. Twenty-four teenage female athletes, 12 with and 12 without PVFMD, breathed into the Airflow Perturbation Device for baseline measures of respiratory resistance and for two successive 1-min trials after treadmill running for up to 12 min...
August 2015: American Journal of Speech-language Pathology
Rita R Patel, Rebecca Venediktov, Tracy Schooling, Beverly Wang
PURPOSE: In this article, our goal was to determine the state of the evidence and the effect of speech-language pathology (SLP) treatment for individuals with paradoxical vocal fold motion (PVFM). METHOD: The American Speech-Language-Hearing Association's National Center for Evidence-Based Practice in Communication Disorders searched 22 electronic databases using key words related to PVFM, speech or voice treatment, and behavioral intervention for articles published through July 2013...
August 2015: American Journal of Speech-language Pathology
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
Linda M Carroll, Melin Tan
OBJECTIVES: Paradoxical vocal fold motion (PVFM) and reverse phonation are characterized by aberrant vocal fold adduction. To date, there have been no studies examining the aerodynamic events during reverse phonation. We present an unusual case of persistent reverse phonation secondary to respiratory distress associated with PVFM. STUDY DESIGN: Case report. METHODS: We present the case of a 42-year-old female with sudden onset of respiratory distress associated with PVFM and persistent reverse phonation...
March 2015: Journal of Voice: Official Journal of the Voice Foundation
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