Objectives/hypothesis: To review our experience with the diagnosis and treatment of exercise-induced paradoxical vocal fold motion disorder (EPVFMD).
Study Design: Single-institution retrospective review and cohort analysis.
Methods: A single-institution retrospective review was performed identifying patients with paradoxical vocal fold motion disorder (PVFMD). Patients with isolated exercise-induced dyspnea were selected for further review. Flexible fiberoptic laryngoscopy (FFL) performed on these patients were reviewed with regard to presence of laryngeal pathology as well as the presence of PVFMD at rest and/or with exertion. The type of therapy was reviewed. Symptom outcomes were graded as complete resolution, improvement, or unchanged following therapy.
Results: There were 758 patients who were identified with PVFMD. A total of 104 patients demonstrated symptoms of PVFMD that were only exercise related (EPVFMD). There were 93/104 (89%) patients who underwent a pre- and post-trigger FFL. Of these, 48/93 (52%) patients had no evidence of PVFMD on initial FFL. After subjecting these patients to exertion, 83/93 (89%) had evidence of PVFMD on postexertion FFL, and 39/93 (42%) patients had evidence of PVFMD on both pre-exertion and postexertion FFL. There were 87/104 (84%) patients who had evidence of laryngeal edema, and 23/104 (23%) had one or more laryngeal lesion on examination. A total of 67 patients were enrolled in laryngeal control therapy and attended at least one session, with 48/67 (72%) demonstrating improvement or complete resolution of their symptoms.
Conclusions: The diagnosis of EPVFMD is augmented with the addition of provocation testing. Findings of PVFMD can be identified at rest when asymptomatic. Laryngeal control therapy is an effective treatment for EPVFMD.
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http://dx.doi.org/10.1002/lary.23654 | DOI Listing |
Am J Otolaryngol
November 2024
Surgery, Division of Otolaryngology, University of New Mexico Hospital, Albuquerque, NM, USA. Electronic address:
Introduction: There is a paucity of literature on pre-adolescent paradoxical vocal fold motion (PVFM), PVFM is a sub-type of inducible laryngeal obstruction. Studies typically focus on older patients, however the discovery of this entity in pre-adolescent pediatric patients has led to more questions about how this entity manifests differently and is treated differently in younger populations. Initially considered psychosomatic and commonly mistaken for asthma, PVFM etiology is now thought to be associated underlying neurologic conditions and may have irritant triggers with proposed mechanisms related to laryngeal hypersensitivity.
View Article and Find Full Text PDFLaryngoscope Investig Otolaryngol
December 2024
Department of Otolaryngology, College of Medicine University of Arizona Tucson Arizona USA.
Introduction: Vocal cord dysfunction (VCD) is a complex disorder characterized by episodic adduction of the vocal folds during inspiration and expiration, which can lead to dyspnea, wheezing, cough, and acute-onset respiratory distress. Currently, there is a lack of standardized criteria among treating physicians across multiple disciplines, including otolaryngologists, pulmonologists, allergists, and speech and language pathologists, for diagnosis and treatment of VCD, although laryngeal-respiratory retraining therapy (LRT) has emerged as the preferred treatment modality.
Objective: In the present study, we examined the efficacy of LRT in patients presenting with a clinical diagnosis of VCD in the presence and absence of laryngeal adduction on laryngoscopy.
Vet Sci
November 2024
Department for Life Quality Studies, Alma Mater Studiorum University of Bologna, Corso D'Augusto, 237, 47921 Rimini, Italy.
Stress and dermatosis or itching are strictly related to mange caused by spp. and spp. mites, which are particularly stressful in alpacas.
View Article and Find Full Text PDFLaryngoscope
October 2024
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Allergol Select
July 2024
Ankara Gulhane Training and Research Hospital, Division of Immunology and Allergic Diseases, Ankara, Turkiye.
Introduction: Anaphylaxis is a severe and life-threatening systemic hypersensitivity reaction. The most frequently encountered causes are foods, drugs, and bee venom, but anaphylaxis may also occur idiopathically. Paradoxical vocal cord movement (PVCM), is a cause of upper airway obstruction due to abnormal adduction of vocal cords during inspiration and, to some degree on expiration.
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