Paradoxical vocal fold motion: presentation and treatment options

Area of Science:

• Otorhinolaryngology
• Pulmonology
• Laryngology

Background:

• Paradoxical vocal fold motion (PVFM) is a rare condition causing inspiratory vocal fold adduction.
• PVFM presents with airway obstruction and distress, necessitating accurate diagnosis by otorhinolaryngologists.
• A history of asthma and psychopathology is often noted in affected individuals.

Purpose of the Study:

• To review the clinical characteristics and management outcomes of patients diagnosed with paradoxical vocal fold motion.
• To evaluate the effectiveness of botulinum toxin and flexible nasolaryngoscopic biofeedback in treating PVFM.

Main Methods:

• Retrospective review of 10 patients diagnosed with paradoxical vocal fold motion over a 6-year period.
• Analysis of patient demographics, presenting symptoms, interventions, and treatment outcomes.
• Literature review to compare findings with existing data on PVFM.

Main Results:

• Eight of the 10 patients were female.
• Six patients required acute airway intervention, and 3 underwent tracheotomy due to respiratory decompensation.
• Six patients had a prior asthma diagnosis; 5 were treated with botulinum toxin and 2 with biofeedback, leading to improved outcomes.

Conclusions:

• Paradoxical vocal fold motion predominantly affects females and can lead to severe respiratory distress.
• Botulinum toxin injections and flexible nasolaryngoscopic biofeedback are effective treatment modalities for PVFM.
• Accurate diagnosis and timely management are crucial for improving patient outcomes in PVFM.