Reduced Asthma Medication Use after Treatment of Pediatric Paradoxical Vocal Fold Motion Disorder

2020 ◽  
Author(s):  
Ryan Ivancic ◽  
Laura Matrka ◽  
Gregory Wiet ◽  
Amy Puckett ◽  
Jennifer Haney ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Medication Use ◽  
Asthma Medication ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

scholarly journals Visual biofeedback for paradoxical vocal fold motion (PVFM)

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Rachelle Alyce LeBlanc ◽  
Daniel Aalto ◽  
Caroline C. Jeffery
Keyword(s):  
Vocal Fold ◽  
Medication Use ◽  
Vocal Folds ◽  
Asthma Medication ◽  
Secondary Outcome ◽  
Post Intervention ◽  
Visual Biofeedback ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

Abstract Objectives Paradoxical vocal fold motion (PVFM) is a common condition where the vocal folds inappropriately adduct during inspiration. This results in dyspnea and occasionally significant distress. The condition is thought to be primarily functional, with behavioural therapy considered mainstay in the non-acute setting. However, practice variations and limited access to speech language pathology (SLP) services can pose management challenges. We aimed to examine the efficacy of surgeon performed visual biofeedback as first-line treatment for PVFM. Study design Prospective, non-randomized, non-comparative clinical study. Methods Adult patients referred for possible PVFM and congruent laryngoscopy findings over a two-year period were included. Patients were excluded if they presented in acute distress, had alternate diagnosis to explain symptomology and/or coexisting untreated lower respiratory pathology. Patients underwent immediate surgeon-performed visual biofeedback on the same visit day. The primary outcome of interest was change in Dyspnea Index (DI) scores pre- and post-intervention 3 months follow-up. The secondary outcome measured was change in asthma medication use from baseline to follow-up. Results Of 34 patients presenting, 25 met inclusion criteria. Of these, 72% were female with an average age of 36.9 ± 14.1. Approximately 48% of patients had a diagnosis of well-controlled asthma at presentation and co-morbid psychiatric diagnoses were common (52%). Pre- and post-intervention analysis showed significant improvement in DI scores (p < 0.001) and reduction in bronchodilator use (p = 0.003). Conclusion This is a prospective study that evaluates the role of visual biofeedback in PVFM patients. Our data suggests that visual biofeedback effectively reduces short-term subjective symptoms and asthma medication use. Level of evidence 3 Graphical abstract

scholarly journals The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

2015 ◽  
Vol 24 (3) ◽  
pp. 470-479 ◽  
Author(s):  
Sally J. K. Gallena ◽  
Nancy Pearl Solomon ◽  
Arthur T. Johnson ◽  
Jafar Vossoughi ◽  
Wei Tian
Keyword(s):  
Repeated Measures ◽  
Vocal Fold ◽  
Female Athletes ◽  
Exercise Duration ◽  
Treadmill Running ◽  
Respiratory Resistance ◽  
The Difference ◽  
Airflow Perturbation Device ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

Purpose An investigational, portable instrument was used to assess inspiratory (R i ) and expiratory (R e ) resistances during resting tidal breathing (RTB), postexercise breathing (PEB), and recovery breathing (RB) in athletes with and without paradoxical vocal fold motion disorder (PVFMD). Method Prospective, controlled, repeated measures within-subject and between-groups design. Twenty-four teenage female athletes, 12 with and 12 without PVFMD, breathed into the Airflow Perturbation Device for baseline measures of respiratory resistance and for two successive 1-min trials after treadmill running for up to 12 min. Exercise duration and dyspnea ratings were collected and compared across groups. Results Athletes with PVFMD had lower than control R i and R e values during RTB that significantly increased at PEB and decreased during RB. Control athletes' R e decreased significantly from RTB to PEB but not from PEB to RB, whereas R i did not change from RTB to PEB but decreased from PEB to RB. Athletes without PVFMD ran longer, providing lower dyspnea ratings. Conclusion Immediately following exercise, athletes with PVFMD experienced increased respiratory resistance that affected their exercise performance. The difference in resting respiratory resistances between groups is intriguing and could point to anatomical differences or neural adaptation in teenagers with PVFMD. The Airflow Perturbation Device appears to be a clinically feasible tool that can provide insight into PVFMD and objective data for tracking treatment progress.

Vocal fold botulinum toxin injection for refractory paradoxical vocal fold motion disorder

2018 ◽  
Vol 129 (4) ◽  
pp. 808-811 ◽  
Author(s):  
Brad deSilva ◽  
Drew Crenshaw ◽  
Laura Matrka ◽  
L. Arick Forrest
Keyword(s):  
Botulinum Toxin ◽  
Vocal Fold ◽  
Botulinum Toxin Injection ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

scholarly journals Laryngeal and respiratory patterns in patients with paradoxical vocal fold motion

2011 ◽  
Vol 105 (12) ◽  
pp. 1891-1895 ◽  
Author(s):  
Thomas Murry ◽  
Sabrina Cukier-Blaj ◽  
Alison Kelleher ◽  
Khalid H. Malki
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

Paradoxical Vocal Fold Motion: A Tutorial on a Complex Disorder and the Speech-Language Pathologist’s Role

2001 ◽  
Vol 10 (2) ◽  
pp. 111-125 ◽  
Author(s):  
Barbara A. Mathers-Schmidt
Keyword(s):  
Vocal Fold ◽  
Psychological Intervention ◽  
Specific Treatment ◽  
Future Research ◽  
Research Attention ◽  
Assessment Protocol ◽  
Complex Disorder ◽  
Speech Language Pathologist ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

Paradoxical vocal fold motion (PVFM) is presented as a complex, poorly understood disorder that merits our clinical and research attention. This tutorial examines PVFM characteristics, etiologies, differential diagnosis, and medical/psychological intervention. The role of the speech-language pathologist in diagnostic evaluation and intervention is delineated. An assessment protocol and specific treatment suggestions are provided. The need for future research is discussed.

Evidence-Based Systematic Review: Effects of Speech-Language Pathology Treatment for Individuals With Paradoxical Vocal Fold Motion

2015 ◽  
Vol 24 (3) ◽  
pp. 566-584 ◽  
Author(s):  
Rita R. Patel ◽  
Rebecca Venediktov ◽  
Tracy Schooling ◽  
Beverly Wang
Keyword(s):  
Vocal Fold ◽  
Experimental Studies ◽  
Communication Disorders ◽  
The State ◽  
Control Group ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Language Pathology ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

Purpose In this article, our goal was to determine the state of the evidence and the effect of speech-language pathology (SLP) treatment for individuals with paradoxical vocal fold motion (PVFM). Method The American Speech-Language-Hearing Association's National Center for Evidence-Based Practice in Communication Disorders searched 22 electronic databases using key words related to PVFM, speech or voice treatment, and behavioral intervention for articles published through July 2013. Identified articles were systematically evaluated to assess the quality of the evidence using a modification of the American Speech-Language-Hearing Association's critical appraisal scheme. Results Sixty-five articles met the search criteria. Only 2 out of the 65 articles were judged to contain adequate evidence to evaluate the effect of SLP treatment for PVFM. All 65 articles exemplify the state of the evidence for SLP treatment for PVFM. Conclusion The state of the evidence for the use of SLP treatment is in its infancy, with a majority of articles in the exploratory stage of research. Consequently, few clinical implications can be drawn at this time. SLP treatment for PVFM is promising; however, there is clearly a pressing need for systematic experimental studies that involve a control group to further the evidence base.

Paradoxical vocal fold motion in children presenting with exercise induced dyspnea

2016 ◽  
Vol 90 ◽  
pp. 165-169 ◽  
Author(s):  
Anne Hseu ◽  
Mykayla Sandler ◽  
Dawn Ericson ◽  
Nohamin Ayele ◽  
Kosuke Kawai ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Exercise Induced ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion

Paradoxical vocal fold motion disorder in the elite athlete: Experience at a large division I university

2013 ◽  
Vol 124 (6) ◽  
pp. 1425-1430 ◽  
Author(s):  
Anna M. Marcinow ◽  
Jennifer Thompson ◽  
Tendy Chiang ◽  
L. Arick Forrest ◽  
Brad W. deSilva
Keyword(s):  
Vocal Fold ◽  
Elite Athlete ◽  
Division I ◽  
Vocal Fold Motion ◽  
Paradoxical Vocal Fold Motion
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