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Updated: May 27, 2026
Investigating the Three-dimensional Flow Separation Induced by a Model Vocal Fold Polyp
Published on: February 3, 2014
Pediatric paradoxical vocal-fold motion: presentation and natural history
Stephen Maturo1, Courtney Hill, Glenn Bunting
1Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.
Insights
Speech therapy effectively treats most children with paradoxical vocal-fold motion (PVFM). For children with PVFM at rest, psychiatric therapy may be more beneficial and indicates a higher likelihood of underlying psychiatric conditions.
Area of Science:
- Pediatric Otolaryngology
- Speech-Language Pathology
- Child Psychiatry
Background:
- Paradoxical vocal-fold motion (PVFM) is a condition affecting children's breathing.
- Multidisciplinary evaluation is crucial for diagnosing and managing complex pediatric airway disorders.
Purpose of the Study:
- To characterize a cohort of pediatric patients with PVFM.
- To evaluate the effectiveness of speech therapy, gastroesophageal reflux disease (GERD) treatment, and psychiatric interventions for PVFM.
Main Methods:
- Retrospective case series of 59 children under 18 years with PVFM.
- Evaluated at a tertiary pediatric airway center over 36 months.
- Chart review of treatment modalities and outcomes.
Main Results:
- Speech therapy achieved a 63% success rate as initial treatment.
- Speech therapy was more effective than antireflux therapy (P = .001).
- 30% of patients were diagnosed with a psychiatric condition; those with inspiratory stridor at rest showed higher psychiatric comorbidity and responded well to psychiatric treatment (100% success).
Conclusions:
- This is the largest pediatric PVFM study to date.
- Speech therapy is the primary effective treatment for most children with PVFM.
- PVFM with symptoms at rest may warrant psychiatric evaluation and treatment due to higher associated psychiatric comorbidities.
Objectives:
To describe (1) a cohort of children with paradoxical vocal-fold motion (PVFM) who were referred to a multidisciplinary airway center and (2) the outcomes of various treatment modalities including speech therapy, gastroesophageal reflux disease treatment, and psychiatric treatment.
Patients And Methods:
This was a case series with chart review of children younger than 18 years with PVFM evaluated at a tertiary care pediatric airway center over a 36-month period.
Results:
Fifty-nine children with PVFM were evaluated. The cohort had a mean age of 13.64 years (range: 8-18 years) and a female-to-male ratio of 3:1. Speech therapy as an initial treatment resulted in a 63% (24 of 38) success rate after an average of 3.7 treatment sessions. Speech therapy was a more successful treatment than antireflux therapy (P = .001). Ten percent (6 of 59) of the children presented with a known psychiatric diagnosis, and 30% (18 of 59) of children in the cohort were ultimately diagnosed with a psychiatric condition. Children with inspiratory stridor at rest had a lower initial success rate with speech therapy (56%), a higher rate of underlying psychiatric disorders (75%), and a high rate of success after psychiatric treatment (100%) that required, on average, 3 sessions over a 2-month period.
Conclusions:
To our knowledge, this is the largest study to date on pediatric PVFM. The majority of children with PVFM improve with speech therapy. Children with PVFM at rest may be better treated with psychiatric therapy than speech therapy. Furthermore, children who present with symptoms at rest may have a higher likelihood of underlying psychiatric disease.
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