Last reviewed: November 2017
Last updated: December  2016

Summary

Definition

History and exam

Key diagnostic factors

  • hx of laryngopharyngeal reflux (LPR) or gastroesophageal reflux (GERD)
  • previous treatment for asthma without response to bronchodilators
  • rapid symptom onset and resolution
  • difficulty inhaling
  • cough
  • inspiratory stridor
  • increased sensitivity to nonspecific triggers after initial exposure
  • palpable laryngeal tension
  • loss of consciousness (LOC)

Risk factors

  • laryngopharyngeal reflux (LPR)
  • GERD
  • asthma
  • occupational/environmental irritant exposure
  • female gender
  • competitive athletics
  • anxiety
  • multisystem atrophy (MSA)
  • muscle tension dysphonia
  • adductor laryngeal breathing dystonia
  • surgery

Diagnostic investigations

1st investigations to order

  • flexible fiberoptic nasendoscopy
  • PFTs/flow-volume plot
Full details

Investigations to consider

  • sinus CT
  • laryngeal sensory discrimination testing
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Sherri K. Zelazny

Senior Clinical Speech Language Pathologist

Surrey Voice Clinic

Abilities Neurological Rehabilitation

Surrey

British Columbia

Canada

Disclosures

SKZ has created a webinar for Northern Speech Services targeted to speech language pathologists for training in evaluation and treatment of paradoxical vocal fold motion and chronic cough. The product is currently being generated and will likely be on the market in the next 12 months.

Susan L. Thibeault

Assistant Professor

Director of Voice and Swallowing Clinic

Division of Otolaryngology - Head and Neck Surgery

University of Wisconsin School of Medicine and Public Health

Health Sciences Learning Center

Madison

WI

Disclosures

SLT has multiple grants from the National Institute of Health, but none of them are on paradoxical vocal fold motion.

Director of Emory Voice Center

Assistant Professor

Emory University Department of Otolaryngology

Emory Voice Center

Emory Crawford Long Hospital

Atlanta

GA

Disclosures

MJ declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Otolaryngology - Head and Neck Surgery

Newcastle University

Honorary Consultant Otolaryngologist

Freeman Hospital

Newcastle-Upon-Tyne

UK

Disclosures

JW declares that she has no competing interests.

Associate Professor

Department of Otorhinolaryngology

Department of Anatomy

University of the Philippines

College of Medicine

Manila

Philippines

Disclosures

RJDCC declares that he has no competing interests.

Professor of Speech Pathology

Department of Otolaryngology - Head and Neck Surgery

Clinical Director of the Voice and Swallowing Center

College of Physicians and Surgeons

Columbia University at New York Presbyterian Hospital

New York

NY

Disclosures

TM declares that he has no competing interests.

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