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Updated: May 23, 2026
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Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Paradoxical vocal cord motion: classification and treatment
L Arick Forrest1, Tiffany Husein, Omar Husein
1Department of Otolaryngology, Ohio State University College of Medicine, Columbus, Ohio 43212, USA. arick.forrest@osumc.edu
The Laryngoscope
|March 22, 2012
Summary
Paradoxical vocal cord motion (PVCM) is often misdiagnosed as asthma. This study found PVCM has multifactorial causes, including psychological factors and medical conditions like laryngeal edema and reflux, not just psychological origins.
Area of Science:
- Otolaryngology
- Pulmonology
- Psychiatry
Background:
- Paradoxical vocal cord motion (PVCM), or vocal cord dysfunction, causes breathing difficulty and is often misdiagnosed as asthma.
- The etiology of PVCM has been unclear, with a historical hypothesis pointing towards psychological factors.
Purpose of the Study:
- To investigate the multifactorial etiology of PVCM.
- To differentiate PVCM from other respiratory conditions and refine diagnostic criteria.
Main Methods:
- Prospective study of 170 adult patients evaluated for PVCM using video laryngoscopy.
- Psychological analysis of 47 newly diagnosed PVCM patients using the Minnesota Multiphasic Personality Inventory and Life Experiences Survey.
- Spirometry with flow volume loop analysis to identify predictors.
Main Results:
- 68.8% of patients evaluated were diagnosed with PVCM.
- Laryngeal edema and reflux were significantly increased in PVCM patients (P = .021, P = .026).
- A flat inspiratory loop on spirometry predicted PVCM (P = .034).
- PVCM patients showed a conversion disorder pattern (P < .01) but no anxiety or stress correlation.
- 11% had normal psychological outcomes, and 4.3% were malingering.
Conclusions:
- PVCM is a descriptive term for a multifactorial condition, not solely psychological.
- Proposed classification: primary (psychological) and secondary (medical, including irritable larynx syndrome and neurologic disorders).
- Etiology should guide treatment strategies for PVCM.
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