Medical Comorbidities for Paradoxical Vocal Fold Motion (Vocal Cord Dysfunction) in the Military Population

Paradoxical vocal fold motion (PVFM), or vocal cord dysfunction (VCD), is a non-organic, behavioral, upper airway disorder primarily characterized by adduction of the true vocal folds during respiration. Recognition of this condition is becoming more prevalent amongst physicians, resulting in an increased number of referrals to speech-language pathologists (SLPs) for assessment and treatment. Diagnosis of PVFM requires a multidisciplinary approach. Treatment for PVFM is also multi-factorial, but is primarily designed to train abduction of the vocal folds during the breathing cycle, allowing easy movement of breath to and from the lungs without laryngeal constriction. Behavioral management is the preferred and most common approach to treatment and may include relaxed throat breathing and laryngeal control exercises during trigger-specific training.

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Vocal Cord Dysfunction and Paradoxical Vocal Fold Motion Disorder

Asthma ◽

10.1093/med/9780199918065.003.0022 ◽

2014 ◽

pp. 288-296 ◽

Cited By ~ 1

Author(s):

Roger W. Fox ◽

Mark C. Glaum

Keyword(s):

Vocal Cord ◽

Vocal Fold ◽

Clinical History ◽

Vocal Cord Dysfunction ◽

Specific Information ◽

Flow Volume ◽

Comorbid Conditions ◽

Vocal Cord Motion ◽

Speech Pathologist ◽

Vocal Fold Motion

Diagnosis of vocal cord dysfunction (VCD) relies on clinical history, inspiratory flow–volume loops, and visualization of vocal cord motion by rhinolaryngoscopy. The treatment of VCD requires a multidisciplinary approach relying on elimination of triggers, treatment of comorbid conditions, and consultation with a speech pathologist. This chapter focuses on VCD as it relates to symptoms that suggest asthma and provides specific information to help with the evaluation of VCD.

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The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

American Journal of Speech-Language Pathology ◽

10.1044/2015_ajslp-14-0110 ◽

2015 ◽

Vol 24 (3) ◽

pp. 470-479 ◽

Cited By ~ 4

Author(s):

Sally J. K. Gallena ◽

Nancy Pearl Solomon ◽

Arthur T. Johnson ◽

Jafar Vossoughi ◽

Wei Tian

Keyword(s):

Repeated Measures ◽

Vocal Fold ◽

Female Athletes ◽

Exercise Duration ◽

Treadmill Running ◽

Respiratory Resistance ◽

The Difference ◽

Airflow Perturbation Device ◽

Vocal Fold Motion ◽

Paradoxical Vocal Fold Motion

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. Exercise duration and dyspnea ratings were collected and compared across groups. Results Athletes with PVFMD had lower than control R i and R e values during RTB that significantly increased at PEB and decreased during RB. Control athletes' R e decreased significantly from RTB to PEB but not from PEB to RB, whereas R i did not change from RTB to PEB but decreased from PEB to RB. Athletes without PVFMD ran longer, providing lower dyspnea ratings. Conclusion Immediately following exercise, athletes with PVFMD experienced increased respiratory resistance that affected their exercise performance. The difference in resting respiratory resistances between groups is intriguing and could point to anatomical differences or neural adaptation in teenagers with PVFMD. The Airflow Perturbation Device appears to be a clinically feasible tool that can provide insight into PVFMD and objective data for tracking treatment progress.

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Vocal fold botulinum toxin injection for refractory paradoxical vocal fold motion disorder

The Laryngoscope ◽

10.1002/lary.27471 ◽

2018 ◽

Vol 129 (4) ◽

pp. 808-811 ◽

Cited By ~ 2

Author(s):

Brad deSilva ◽

Drew Crenshaw ◽

Laura Matrka ◽

L. Arick Forrest

Keyword(s):

Botulinum Toxin ◽

Vocal Fold ◽

Botulinum Toxin Injection ◽

Vocal Fold Motion ◽

Paradoxical Vocal Fold Motion

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Methacholine Challenge Testing in the Diagnosis of Paradoxical Vocal Fold Motion

The Laryngoscope ◽

10.1097/01.mlg.0000228007.74561.33 ◽

2006 ◽

Vol 116 (9) ◽

pp. 1558-1561 ◽

Cited By ~ 21

Author(s):

Joel Guss ◽

Natasha Mirza

Keyword(s):

Vocal Fold ◽

Methacholine Challenge ◽

Challenge Testing ◽

Methacholine Challenge Testing ◽

Vocal Fold Motion ◽

Paradoxical Vocal Fold Motion

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Laryngeal and respiratory patterns in patients with paradoxical vocal fold motion

Respiratory Medicine ◽

10.1016/j.rmed.2011.08.023 ◽

2011 ◽

Vol 105 (12) ◽

pp. 1891-1895 ◽

Cited By ~ 10

Author(s):

Thomas Murry ◽

Sabrina Cukier-Blaj ◽

Alison Kelleher ◽

Khalid H. Malki

Keyword(s):

Vocal Fold ◽

Vocal Fold Motion ◽

Paradoxical Vocal Fold Motion

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Paradoxical Vocal Fold Motion: A Tutorial on a Complex Disorder and the Speech-Language Pathologist’s Role

American Journal of Speech-Language Pathology ◽

10.1044/1058-0360(2001/012) ◽

2001 ◽

Vol 10 (2) ◽

pp. 111-125 ◽

Cited By ~ 44

Author(s):

Barbara A. Mathers-Schmidt

Keyword(s):

Vocal Fold ◽

Psychological Intervention ◽

Specific Treatment ◽

Future Research ◽

Research Attention ◽

Assessment Protocol ◽

Complex Disorder ◽

Speech Language Pathologist ◽

Vocal Fold Motion ◽

Paradoxical Vocal Fold Motion

Paradoxical vocal fold motion (PVFM) is presented as a complex, poorly understood disorder that merits our clinical and research attention. This tutorial examines PVFM characteristics, etiologies, differential diagnosis, and medical/psychological intervention. The role of the speech-language pathologist in diagnostic evaluation and intervention is delineated. An assessment protocol and specific treatment suggestions are provided. The need for future research is discussed.

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