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Paradoxical vocal cord motion: a review focused on multiple system atrophy
Keisuke Shiba1, Shiroh Isono, Ken Nakazawa
1Department of Otolaryngology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba City, Chiba 260-8670, Japan. shibak1963@yahoo.co.jp
Auris, Nasus, Larynx
|May 8, 2007
Summary
Paradoxical vocal cord motion (PVCM) involves vocal cord adduction during breathing, causing airway obstruction. This review explores PVCM mechanisms, particularly in multiple system atrophy (MSA), and treatment options.
Area of Science:
- Respiratory Medicine
- Neurology
- Laryngology
Background:
- Paradoxical vocal cord motion (PVCM) is a condition where vocal cords adduct during inhalation, obstructing the airway.
- Nonorganic PVCM is thought to arise from laryngeal reflex acceleration.
- Multiple system atrophy (MSA) is a neurological disorder that can cause nocturnal laryngeal stridor due to PVCM.
Purpose of the Study:
- To elucidate the underlying mechanisms of nonorganic and MSA-related PVCM.
- To examine the interplay between PVCM and airway reflexes.
- To review treatment strategies for MSA-related PVCM.
Main Methods:
- This study is a review of existing literature.
- Analysis of pathophysiology, reflex mechanisms, and treatment options for PVCM.
Main Results:
- Nonorganic PVCM stems from abnormal laryngeal output-feedback control, often triggered by exaggerated responses to stimuli.
- MSA-related PVCM appears linked to airway reflexes and paradoxical central outputs from pontomedullary respiratory center damage.
- Continuous positive airway pressure (CPAP) is a recommended treatment for MSA-related PVCM by suppressing inspiratory adductor activation.
Conclusions:
- Understanding the reflex and central control abnormalities is key to managing PVCM.
- CPAP offers a therapeutic approach for MSA-related PVCM by modulating airway reflexes.
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