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Irritant-Induced Paradoxical Vocal Fold Motion Disorder: Diagnosis and Management
Anna M Marcinow1, Jennifer Thompson2, L Arick Forrest3
1Department of Otolaryngology, Group Health, Cincinnati, Ohio, USA.
Objectives:
To review our experience with the diagnosis and treatment of irritant-induced paradoxical vocal fold motion disorder (IPVFMD).
Study Design:
Retrospective chart review.
Setting:
Tertiary academic referral center.
Subjects And Methods:
Thirty-four cases that met IPVFMD criteria and 76 cases of non-IPVFMD were selected from a database of patients with paradoxical vocal fold motion disorder-the diagnosis of which was made on the basis of flexible fiberoptic laryngoscopy and augmented by an odor challenge. Clinical charts were reviewed to document history of environmental allergies, pulmonary disease, gastroesophageal reflux, psychiatric disorder, fibromyalgia, tobacco use, alcohol use, dysphonia, cough, dysphagia, and treatment outcomes.
Results:
There were no statistical differences between the IPVFMD and non-IPVFMD groups. Of the patients who were assigned and attended laryngeal control therapy, 13 (65%) reported improvement of symptoms. Symptom improvement increased to 100% in those patients who attended at least 2 laryngeal control therapy sessions.
Conclusions:
IPVFMD should be considered in patients presenting with respiratory symptoms after irritant exposure. Sensitivity of diagnosis can be improved via a standardized approach consisting of a careful history and physical examination, including laryngoscopy in the presence of triggers. Laryngeal control therapy is a well-tolerated and effective method of managing IPVFMD.
Insights
Irritant-induced paradoxical vocal fold motion disorder (IPVFMD) requires careful diagnosis and can be effectively managed with laryngeal control therapy. Early intervention and standardized diagnostic approaches improve patient outcomes for this respiratory condition.
Area of Science:
- Otolaryngology
- Pulmonology
- Speech-Language Pathology
Background:
- Paradoxical vocal fold motion disorder (PVFMD) can be triggered by irritants, leading to specific diagnostic and therapeutic challenges.
- Irritant-induced paradoxical vocal fold motion disorder (IPVFMD) presents with respiratory symptoms following exposure to environmental or occupational triggers.
Purpose of the Study:
- To review the diagnostic and treatment experiences with irritant-induced paradoxical vocal fold motion disorder (IPVFMD).
- To evaluate the effectiveness of laryngeal control therapy in managing IPVFMD.
Main Methods:
- A retrospective chart review was conducted at a tertiary academic referral center.
- Thirty-four cases of IPVFMD and 76 non-IPVFMD cases were analyzed.
- Diagnosis was confirmed via flexible fiberoptic laryngoscopy with an odor challenge, and patient histories were reviewed for relevant comorbidities and exposures.
Main Results:
- No significant statistical differences were found between IPVFMD and non-IPVFMD groups in the reviewed parameters.
- Laryngeal control therapy resulted in symptom improvement for 65% of patients who attended sessions.
- 100% symptom improvement was observed in patients attending at least two laryngeal control therapy sessions.
Conclusions:
- IPVFMD should be considered in patients with respiratory symptoms post-irritant exposure.
- A standardized diagnostic approach, including history, physical examination, and laryngoscopy during trigger exposure, can enhance diagnostic sensitivity.
- Laryngeal control therapy is a well-tolerated and effective treatment for managing IPVFMD.
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