Breathing disorder that is frequently mistaken for asthma.
Accurate diagnosis is made by a multidisciplinary team, which can include a speech language pathologist, a primary care physician, an asthma/allergy specialist, a pulmonologist, a psychologist, a psychiatrist, a sports medicine specialist, an athletic trainer, and a gastroenterologist.
Diagnosis is established through the case history, laryngeal visualization, and pulmonary function studies.
Behavioral therapy by a speech language pathologist is the standard treatment.
Paradoxical vocal fold motion (PVFM), also called paradoxical vocal cord dysfunction, is a breathing disorder characterized by approximation rather than abduction/opening of the vocal folds during inspiration. This can result in upper-airway obstruction and stridor. Diagnosis is most often based upon exclusion of other differentials.
History and exam
- hx of laryngopharyngeal reflux (LPR) or gastroesophageal reflux (GERD)
- previous treatment for asthma without response to bronchodilators
- rapid symptom onset and resolution
- difficulty inhaling
- inspiratory stridor
- increased sensitivity to nonspecific triggers after initial exposure
- palpable laryngeal tension
- loss of consciousness (LOC)
Senior Clinical Speech Language Pathologist
Surrey Voice Clinic
Abilities Neurological Rehabilitation
SKZ has received royalties from Northern Speech Services for a webinar created for continuing education in evaluation and treatment of paradoxical vocal fold motion and chronic cough.
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
SLT has had multiple grants from the National Institutes of Health, National Institute on Deafness and Other Communication Disorders (NIDCD), but none of them are on paradoxical vocal fold motion.
Director of Emory Voice Center
Emory University Department of Otolaryngology
Emory Voice Center
Emory Crawford Long Hospital
MJ declares that he has no competing interests.
Professor of Otolaryngology - Head and Neck Surgery
Honorary Consultant Otolaryngologist
JW declares that she has no competing interests.
Department of Otorhinolaryngology
Department of Anatomy
University of the Philippines
College of Medicine
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
TM declares that he has no competing interests.
Use of this content is subject to our disclaimer