title: Medical comorbidities for paradoxical vocal fold motion (vocal cord dysfunction) in the military population.
abstract: OBJECTIVE
  This study aimed to describe the demographic characteristics of patients diagnosed with paradoxical vocal fold motion (PVFM) at Walter Reed Army Medical Center (WRAMC), and to document common medical comorbidities. The military population was expected to differ from the general population because of a presumed association between high physical demands and PVFM.
  
  
  METHODS
  Retrospective chart review of active-duty (AD) military personnel compared with a natural control group of non-AD patients.
  
  
  METHODS
  Reports of asthma, allergy, gastroesophageal reflux disease (GERD), and postnasal drip (consequent to chronic sinusitis) were recorded for patients referred to the Speech Pathology Clinic at WRAMC with a diagnosis of PVFM from 1996 to 2001.
  
  
  RESULTS
  The cohort consisted of 265 patients, 127 of whom were on AD status. The AD group was significantly younger and represented a narrower age range (17-53 years) than the non-AD patients (8-80 years), and had a more balanced sex ratio (1.2:1 vs 2.9:1). Eighty percent of all patients had at least one of the medical comorbidities surveyed, and 51% had two or more factors. GERD and allergies were reported most commonly by both groups; only asthma occurred significantly more in non-AD than AD patients.
  
  
  CONCLUSIONS
  PVFM referrals of AD personnel of the US military are characterized by younger patients and a smaller female:male ratio as compared with non-AD patients. Based on the preponderance of men in the military, the number of females in the AD group remained disproportionately large. Multiple medical comorbidities were commonly documented by both groups; the only significant difference was a greater prevalence of asthma in the non-AD group. These data reinforce the need for appropriate differential diagnosis in all patients.
authors.affiliation: Department of Surgery, Army Audiology and Speech Center, Walter Reed Army Medical Center, Washington, District of Columbia, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Gurevich-Uvena
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Parker
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Fitzpatrick
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Makashay
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Perello
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Blair
authors.forename: Nancy Pearl
authors.initials: NP
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D014827:Vocal Cords / Q000503:physiopathology*; D055815:Young Adult