Paradoxical vocal fold motion: Presentation and treatment options

Paradoxical vocal fold motion is a rare disorder in which adduction of the folds occurs on inspiration. The disorder presents with signs of airway obstruction and often airway distress, so proper diagnosis by the otorhinolaryngologist is critical to subsequent management. We present a retrospective...

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Bibliographic Details
Published in:Journal of voice 2000-03, Vol.14 (1), p.99-103
Main Authors: Altman, Ken W., Mirza, Natasha, Ruiz, Cesar, Sataloff, Robert T.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Airway Obstruction - complications
Airway Obstruction - surgery
Asthma
Biofeedback
Biofeedback, Psychology
Botulinum toxin
Botulinum Toxins, Type A - therapeutic use
Child
Female
Follow-Up Studies
Humans
Laryngeal Diseases - complications
Laryngeal Diseases - drug therapy
Laryngeal Diseases - physiopathology
Laryngeal disorder
Male
Middle Aged
Neuromuscular Agents - therapeutic use
Paradoxical motion
Retrospective Studies
Tracheotomy
Tracheotomy - methods
Vocal Cords - innervation
Vocal Cords - physiopathology
Vocal fold
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Summary:Paradoxical vocal fold motion is a rare disorder in which adduction of the folds occurs on inspiration. The disorder presents with signs of airway obstruction and often airway distress, so proper diagnosis by the otorhinolaryngologist is critical to subsequent management. We present a retrospective review of 10 patients with the diagnosis of paradoxical vocal fold motion seen over a 6-year period. Eight patients were females, and 6 required an acute airway intervention at presentation; 3 patients eventually underwent tracheotomy for respiratory decompensation. Six patients had a prior diagnosis of asthma, and this was determined to contribute to their respiratory status. Five patients were treated with botulinum toxin and 2 with flexible nasolaryngoscopic biofeedback, which improved the outcome. A review of the literature confirms a female predominance of patients presenting with paradoxical adduction and airway distress, often with a history of asthma and psychopathology. Our experience with botulinum toxin and biofeedback suggests that these procedures are viable treatment options in the management of patients with this disorder.
ISSN:0892-1997
1873-4588
DOI:10.1016/S0892-1997(00)80099-5