No abstract

Objective: To evaluate demographic and videolaryngoscopic features in a large series of juveniles with paradoxical vocal cord dysfunction (PVCD).Design: Case series data from videolaryngoscopic tapes retrospectively evaluated in a masked, controlled fashion, and demographic data collected via retrospective medical chart review.Setting: A tertiary care otolaryngology and speech pathology referral center.Patients: Twenty-two patients with PVCD aged 18 years and younger diagnosed as having PVCD at The Ohio State University Voice Institute, Columbus.Main Outcome Measures: Age, sex, social history, and medical history (demographic); epiglottic position, arytenoid and interarytenoid appearance, phase 0 stability, true vocal cord respiratory motion, degree of anteroposterior (AP) constriction, and false vocal cord adduction (videolaryngoscopic).Results: Of 22 patients, 18 were girls, and 12 had significant social stressors, particularly organized sports. Nineteen patients had posterior laryngeal changes commonly found in gastroesophageal reflux disease. Twelve patients demonstrated abnormal true vocal cord adduction during quiet respiration. Seven patients demonstrated supraglottic anteroposterior constriction and false vocal cord approximation during phonation. Conclusions:Juvenile PVCD is more common in girls and is associated with social stresses. Anatomic laryngeal changes typically associated with gastroesophageal reflux disease are extremely common in these patients. Juveniles with PVCD frequently demonstrate abnormal true vocal cord adduction during quiet respiration. We recommend that initial evaluation of juvenile patients for possible PVCD be conducted via transnasal fiberoptic laryngoscopy while the patient is asymptomatic, and that strong consideration be given to empiric pharmacological treatment of gastroesophageal reflux disease in juveniles diagnosed as having PVCD.

The purpose of this study was to ascertain the normal relation of swallowing apnea (SA) onset relative to lingual bolus propulsion along with factors that may alter this relation. Forty adults, composed of 10 men and 10 women in each of 2 age groups (i.e., 20–30 and 63–79 years) participated. SA onset was assessed during 5- and 20-ml bolus volumes of water and apple juice across 3 trials. The effects of age, gender, bolus volume, bolus viscosity, and gustation on SA onset relative to lingual bolus propulsion were examined. A significant interaction of Age × Gender × Volume was found. In general, older adults initiated SA onset earlier than young adults, and large boluses elicited an earlier SA onset than small boluses regardless of group. Young men demonstrated significantly later SA onset than the older men for large volumes; this difference was not observed for small volumes, nor was it found between young and older women. SA onset also was assessed during 5-ml bolus volumes of thin apple juice, thick apple juice, and applesauce across three trials. A significant main effect of viscosity was found revealing that SA onset was initiated later as bolus viscosity increased. Thus, the results of this investigation provided data on the relation of SA onset relative to lingual bolus propulsion in individuals with normal swallowing and how this relation changes as a function of age, gender, bolus volume, bolus viscosity, and gustation.

No abstract

No abstract