Presented at Triological Society annual meeting at the Combined Otolarygology Spring Meetings, Orlando, Florida, U.S.A., April 12–13, 2013.
Paradoxical vocal fold motion disorder in the elite athlete: Experience at a large division I university
Article first published online: 13 DEC 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 6, pages 1425–1430, June 2014
How to Cite
Marcinow, A. M., Thompson, J., Chiang, T., Forrest, L. A. and deSilva, B. W. (2014), Paradoxical vocal fold motion disorder in the elite athlete: Experience at a large division I university. The Laryngoscope, 124: 1425–1430. doi: 10.1002/lary.24486
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 27 MAY 2014
- Article first published online: 13 DEC 2013
- Accepted manuscript online: 26 OCT 2013 04:39AM EST
- Manuscript Accepted: 23 OCT 2013
- Manuscript Revised: 14 OCT 2013
- Manuscript Received: 27 MAR 2013
- Paradoxical vocal fold dysfunction;
- laryngeal control therapy
To review our experience at a large division I university with the diagnosis and management of paradoxical vocal fold motion disorder (PVFMD) in elite athletes.
A single institution retrospective review and cohort analysis.
All elite athletes (division I collegiate athletes, triathletes, and marathon runners) with a diagnosis of PVFMD were identified. All patients underwent flexible fiberoptic laryngoscopy (FFL) to confirm the diagnosis of PVFMD. The type of PVFMD therapy was identified and efficacy of treatment was graded based on symptom resolution.
Forty-six consecutive athletes with PVFMD were identified. A total of 30/46 (65%) were division 1 collegiate athletes and 16/46 (35%) were triathletes or marathon runners. In comparison to a nonathlete PVFMD cohort, athletes were less likely to present with a history of reflux (P < 0.01), psychiatric diagnosis (P < 0.01), dysphonia (P < 0.01), cough (P = 0.02), or dysphagia (P < 0.01). The use of postexertion FFL provided additional diagnostic information in 11 (24%) patients. Laryngeal control therapy (LCT) was recommended for 45/46. A total of 36/45 attended at least one LCT session and 25 (69%) reported improvement of symptoms. Additionally, biofeedback, practice-observed therapy, and thyroarytenoid muscle botulinum toxin injection were required in three, two, and two patients, respectively.
The addition of postexertion FFL improves the sensitivity to detect PVFMD in athletes. PVFMD in athletes responds well to LCT. However, biofeedback, practice-observed therapy, and botulinum toxin injection may be required for those patients with an inadequate response to therapy.
Level of Evidence
4. Laryngoscope, 124:1425–1430, 2014