11:16 AM: Vocal Fold Augmentation by Autologous Fat Injection with Lipostructure Procedure

Abstract

Objectives: Paradoxical vocal fold motion (PVFM) is a condition that exhibits inappropriate adduction of the vocal cords during inspiration, with females comprising the majority of the patients. As awareness has increased, more patients are being referred for evaluation. No study to date has reported additional laryngeal pathologies found concurrent to PVFM.Methods: A retrospective chart review of patients referred for evaluation of "paradoxical vocal fold motion" between July 2002 and December 2002 was performed. Questionnaires were completed by the patients at the time of the office visit. Data collected from the medical record included age, sex, duration of symptoms prior to evaluation, asthma, gastroesophageal reflux symptoms, and laryngoscopic findings. Exercise stress testing was performed when suitable. The diagnosis of PVFM was made based on history and laryngoscopy.Results: 32 patients were identified. There was a 29:3 (90.6%) female predominance. Mean age of presentation was at 28 years (12-67 years). The median time from the onset of respiratory symptoms to diagnosis was 4.5 years (range, 0.5 to 30 years). 17/32 (53%) had asthma. 12/32 had laryngeal findings suggestive of GERD. 4/32 (12%) had laryngoscopic findings of chronic laryngitis. 10/32 (31%) had additional findings including laryngomalacia, vocal fold motion impairment, sulcus vocalis, nodules, subglottic stenosis, and Reinke's edema.Conclusions: PVFM is still under-recognized, as demonstrated by a median duration of symptoms prior to diagnosis of 4.5 years. Additional laryngeal pathologies may be seen in 1/3 of patients. As in previously published studies, there was a female predominance and relative prevalence of asthma.