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Paradoxical Vocal Fold Motion: A Sensory-Motor Laryngeal Disorder

Authors

  • Sabrina Cukier-Blaj SLP, MS,

    1. From the Department of Otolaryngology–Head & Neck Surgery, Columbia University Medical Center, New York, NY, USA
    2. Integrated Acoustic Analysis and Cognition Laboratory, Catholic University of São Paulo; CEFAC–Health & Education, São Paulo, Brazil
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  • Arnaud Bewley MD,

    1. From the Department of Otolaryngology–Head & Neck Surgery, Columbia University Medical Center, New York, NY, USA
    Current affiliation:
    1. University of Pennsylvania, Department of Otolaryngology–Head and Neck Surgery, Philadelphia, Pennsylvania, U.S.A.
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  • Jonathan E. Aviv MD,

    1. From the Department of Otolaryngology–Head & Neck Surgery, Columbia University Medical Center, New York, NY, USA
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  • Thomas Murry PhD

    Corresponding author
    1. From the Department of Otolaryngology–Head & Neck Surgery, Columbia University Medical Center, New York, NY, USA
    • Thomas Murry, PhD, Department of Otolaryngology–Head and Neck Surgery, Columbia University, 180 Fort Washington Ave. HP 8-812, New York, NY 10032, U.S.A.
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  • This research was presented at the American Bronchoesophageal Association at the Combined Otolaryngology Spring Meetings in San Diego, California, U.S.A., April, 26, 2007.

Abstract

Objectives: The purpose of this study is to determine the laryngeal sensitivity (LS) thresholds and the ratings of laryngopharyngeal reflux symptoms in patients with paradoxical vocal fold motion (PVFM).

Methods: This is a chart review following Institutional Review Board approval of 75 patients from January 2006 to June 2007. The patients were diagnosed with PVFM following case history, transnasal flexible laryngoscopy and spirometric testing. The data analyzed consisted of the reflux symptom index (RSI) and laryngopharyngeal sensitivity (LS). Laryngeal sensitivity and RSI were graded according to mild, moderate, or severe.

Results: There were 12 (16%) patients with normal RSI scores, 37 patients (49.3%) with moderate RSI (RSI 11–22), and 26 patients (34.7%) with severe RSI (RSI >22). The right LS was normal in 11 patients (14.7%), moderately impaired in 16 patients (21.3%), and severely impaired in 48 (64%) patients. The left LS showed normal sensation in 11 patients (14.7%), moderately impaired LS in 13 patients (17.3%), and severe impairment in 51 patients (68%). Only one patient had both normal sensation and normal RSI, and 70.4% of patients had abnormal RSI and sensation thresholds.

Conclusions: Patients diagnosed with PVFM had a high prevalence of symptoms related to LPR and markedly reduced LS. These findings suggest that PVFM may be triggered by reduced peripheral sensation or laryngeal inflammation.

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