Concurrent laryngeal abnormalities in patients with paradoxical vocal fold dysfunction.
OBJECTIVE
Our goal was to investigate the presence of laryngeal abnormalities is patients with paradoxical vocal fold dysfunction (PVFD).


METHODS
A retrospective chart review was performed of patients referred for evaluation of paradoxical vocal fold dysfunction between July 2002 and December 2002. The patients completed questionnaires at the time of the office visit. Data collected from the medical record included age, gender, duration of symptoms before evaluation, asthma, gastroesophageal reflux symptoms, and laryngoscopic findings. Exercise stress test was performed when suitable. The diagnosis of PVFD was made based on patient history and laryngoscopy.


RESULTS
Thirty patients were identified. There was a 27:3 (90%) female predominance, and mean age of presentation at was 28 years (range, 12 to 67 years). The median time from the onset of respiratory symptoms to diagnosis was 4.5 years (range, 0.5 to 30 years). Of the 30 patients, 17 (56%) had asthma, 16 had laryngeal findings suggestive of gastroesophageal reflex disease, 4 (12%) had laryngoscopic findings of chronic laryngitis, and 10 (33%) had additional findings, including laryngomalacia, vocal fold motion impairment, sulcus vocalis, nodules, and subglottic stenosis, mostly in the exercise-induced group.


CONCLUSIONS
Concomitant laryngeal abnormalities are present in a many patients with PVFD, particularly in those with exercise-induced symptoms. Laryngoscopy is important in the management of these patients.
Patel
Nalin J
NJ
Division of Laryngology, Center for Communication and Swallowing Disorders, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee 53226, USA.
Jorgensen
Carol
C
Kuhn
Joan
J
Merati
Albert L
AL
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D007827:Laryngitis / Q000453:epidemiology; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014827:Vocal Cords / Q000503:physiopathology*