Endoscopic and stroboscopic description of adults with paradoxical vocal fold dysfunction

Treole, Kathleen; Trudeau, Michael D.; Forrest, L. Arick

doi:10.1016/s0892-1997(99)80068-x

Cited by 44 publications

(46 citation statements)

References 6 publications

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“…While perceptual voice analysis was not conducted in the study by Treole et al [6] , these findings could suggest the potential for voice problems to occur in this population. Treole et al [6] questioned whether the abnormal findings were linked to excessive muscle force or mistimings associated with phonation. The severity of voice features appeared to be greater in the CC and combined CC/PVFM groups than in the PVFM group in the current study.…”

Section: Discussionmentioning

confidence: 81%

“…Specifically Treole et al [6] reported an increased prevalence of lateral ventricular constriction, decreased mucosal wave and decreased lateral amplitude in individuals with PVFM. While perceptual voice analysis was not conducted in the study by Treole et al [6] , these findings could suggest the potential for voice problems to occur in this population. Treole et al [6] questioned whether the abnormal findings were linked to excessive muscle force or mistimings associated with phonation.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors contend that voice quality is normal between episodes of PVFM [26][27][28] , whereas Treole et al [6] found endoscopic and stroboscopic evidence of residual laryngeal muscle tension after PVFM attacks and concluded that this could contribute to altered phonatory characteristics in these patients. Specifically Treole et al [6] reported an increased prevalence of lateral ventricular constriction, decreased mucosal wave and decreased lateral amplitude in individuals with PVFM. While perceptual voice analysis was not conducted in the study by Treole et al [6] , these findings could suggest the potential for voice problems to occur in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Copyright © 2007 S. Karger AG, Basel Voice symptoms are a common feature associated with chronic cough (CC) and paradoxical vocal fold movement (PVFM) [1][2][3][4][5] ; however, perceptual voice characteristics in individuals with CC and PVFM have not been systematically investigated especially in comparison to other related laryngeal conditions such as muscle tension dysphonia (MTD). Laryngeal abnormalities have been reported between symptomatic episodes of PVFM, suggesting that laryngeal function is affected in both respiration and phonation in this disorder [6] . There is also evidence to suggest laryngeal involvement in CC [7] , which could imply abnormalities in voice quality in these conditions.…”

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confidence: 93%

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Perceptual Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

Vertigan

Theodoros

Winkworth

et al. 2007

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Voice problems have been reported in chronic cough (CC) and paradoxical vocal fold movement (PVFM), however, there is a lack of a systematic description of voice characteristics in these conditions. This study examined the perceptual voice characteristics of 56 individuals with CC, 8 with PVFM and 55 with both CC and PVFM, compared to 25 people with muscle tension dysphonia (MTD) and 27 healthy controls. There was a high prevalence of abnormal voice quality in the CC and PVFM groups compared with healthy controls. More than one third of participants with CC and PVFM demonstrated strained, rough and/or breathy voices to a moderate or severe degree. The perceptual features in CC and PVFM were similar to those in MTD with greater severity evident in MTD. Possible mechanisms for abnormalities in voice quality include the presence of muscle tension and the frequency of coughing. These results have implications for the identification and management of voice disorders in CC and PVFM and suggest that clinicians should be alert to the incidence of voice abnormalities in these populations.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

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Perceptual Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

Vertigan

Theodoros

Winkworth

et al. 2007

Folia Phoniatr Logop

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“…Recent studies have also identified an increased prevalence of self-reported voice symptoms, atypical findings during formal perceptual voice analysis, and endoscopic and stroboscopic abnormalities during phonation in individuals with CC and PVFM [8][9][10] . Speech pathologists are becoming increasingly involved in the management of CC and PVFM [11][12][13] , however there is limited information to guide the management of voice problems occurring in these conditions.…”

Section: Introductionmentioning

confidence: 99%

Acoustic and Electroglottographic Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

Vertigan

Theodoros

Winkworth

et al. 2008

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Objective: Chronic cough (CC) and paradoxical vocal fold movement (PVFM) may be associated with voice problems. Objective acoustic and electroglottographic (EGG) measures have the capacity to delineate these vocal characteristics. This study investigated acoustic and EGG voice features of CC and PVFM. Patients and Methods: Acoustic and EGG findings were compared among 5 groups of participants. The first 3 groups, CC (n = 56), PVFM (n = 8) and combined CC-PVFM (n = 55), included individuals with cough and respiratory symptoms that persisted despite medical treatment. Groups 4 and 5 included individuals with muscle tension dysphonia (n = 25) and healthy controls (n = 27). Results: Participants with CC/PVFM recorded reduced phonation times (p < 0.001), greater jitter (p < 0.001), reduced harmonic to noise ratio (p = 0.001), reduced phonation range (p = 0.007) and shorter closed phase of vocal fold vibration (p = 0.006) in comparison to healthy controls. Females with CC had reduced fundamental frequency in connected speech (p = 0.009). There was consistent overlap between the participants with CC and those with PVFM. Duration of closed phase and fundamental frequency were lower in the participants with CC and PVFM than in those with muscle tension dysphonia. Conclusion: These results confirm abnormalities in acoustic and EGG voice features in CC and PVFM.

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Paradoxical vocal cord motion: Classification and treatment

Husein²,

2012

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Paradoxical vocal cord motion (PVCM), or vocal cord dysfunction, is a descriptive term for inappropriate adduction of the vocal folds during respiration. The laryngeal mistiming leads to breathing difficulty and is often misdiagnosed as refractory asthma. The etiology of PVCM has been unclear but has long been hypothesized to be psychological. The present thesis is a prospective study of 170 patients older than 18 years being evaluated for PVCM, with 117 of the 170 (68.8%) identified as having PVCM by video laryngoscopy. Laryngeal edema (P = .021) and reflux (P = .026) were increased in patients with PVCM. A flat inspiratory arm of the flow volume loop during spirometry testing was a predictor of PVCM (P = .034). A subgroup of 47 newly diagnosed patients with PVCM underwent psychological analysis. The psychological profiles were elucidated using the Minnesota Multiphasic Personality Inventory and the Life Experiences Survey to evaluate stress. Compared to established normative data, PVCM demonstrated a conversion disorder pattern (P < .01) but not an anxiety disorder or a correlation with stress. A subgroup, 11 of the 47 (23.4%), had normal psychological outcomes, and two of the 47 (4.3%) were identified as malingering. Previous studies have suggested that PVCM is strictly a psychological disorder. It is proposed that PVCM is a descriptive term that is multifactorial and the etiology should direct treatment. A classification scheme divides PVCM into primary, or psychological, and secondary. The secondary form consists of medical disorders divided into irritable larynx syndrome and neurologic disorders.

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Endoscopic and stroboscopic description of adults with paradoxical vocal fold dysfunction

Cited by 44 publications

References 6 publications

Perceptual Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

Perceptual Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

Acoustic and Electroglottographic Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

Paradoxical vocal cord motion: Classification and treatment

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