Paradoxical movement of the vocal cords as a cause of stridor

Rogers, John; Stell, P. M.

doi:10.1017/s0022215100085169

Cited by 89 publications

(50 citation statements)

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“…The term "paradoxical," with regard to abnormal adduction of TVCs during respiration, was first used in 1978. 1 Concurrently, descriptions of "Munchausen stridor" 2 and "factitious asthma" 3 appeared in the literature in response to the apparent lack of organic pathology associated with, and the possible psychological cause of, this clinical entity. During the past 20 years, the characteristic history, physical examination results, and laboratory findings for PVCD, as well as various treatment options for this disorder, have been the subject of intense investigation.…”

Section: Discussionmentioning

confidence: 99%

“…From January 1,1990, to December 31, 1997, 26 juveniles (Յ18 years) diagnosed as having PVCD at The Ohio State University Department of Otolaryngology and Voice Institute were referred for evaluation after negative findings on thorough pulmonary workup in The Ohio State University Department of Pulmonary Medicine, the Pulmonary Medicine Division of Columbus Children's Hospital, or a similar outlying pulmonary medicine clinic in Ohio. Their initial evaluations at the Voice Institute included a thorough history and complete head and neck examination.…”

Section: Methodsmentioning

confidence: 99%

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Paradoxical Vocal Cord Dysfunction in Juveniles

Powell¹,

Karanfilov²,

Beechler³

et al. 2000

Arch Otolaryngol Head Neck Surg

139

106

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Paradoxical Vocal Cord Dysfunction in Juveniles

Powell¹,

Karanfilov²,

Beechler³

et al. 2000

Arch Otolaryngol Head Neck Surg

139

106

View full text Add to dashboard Cite

show abstract

“…The diagnosis is frequently unrecognized, and many patients have been incorrectly treated for asthma as long as 15 years. 3 Because of its dramatic presentation, VCD has resulted in both endotracheal intubation and emergent tracheostomy. Although infrequently diagnosed prior to the early 1990s, increased awareness and recognition of VCD have led to descriptions of the various etiologies and treatment of this disorder.…”

mentioning

confidence: 99%

Vocal Cord Dysfunction

Morris¹,

Allan²,

Perkins³

2006

Clinical Pulmonary Medicine

112

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Vocal cord dysfunction, a syndrome of paradoxical inspiratory closure of the vocal cords, is becoming more frequently recognized and diagnosed recently since its initial modern description 30 years ago. Initially described as single case reports, the first case series in 1983 helped to clarify the typical patient and findings of vocal cord dysfunction. Recent investigations have elucidated specific etiologies such as gastroesophageal reflux, exercise, and irritants as causative factors in addition to the numerous associated psychologic factors. Speech therapy and psychotherapy have been used extensively with vocal cord dysfunction patients, but the optimal treatment has yet to be prospectively studied. This manuscript provides a comprehensive review of the reported causative factors and treatments for vocal cord dysfunction.

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“…Paradoxical vocal cord movement is characterized by vocal cord adduction during inspiration and decreased inspiratory flow. First reported in 1978 by Rogers and Stell [2], it is often misdiagnosed as laryngospasm, bronchospasm, or airway obstruction with stridor. To distinguish paradoxical vocal cord movement from other causes of inspiratory stridor, fiberoptic laryngoscopy may be performed [3].…”

Section: Discussionmentioning

confidence: 99%