title: Irritant-Induced Paradoxical Vocal Fold Motion Disorder: Diagnosis and Management.
abstract: OBJECTIVE
  To review our experience with the diagnosis and treatment of irritant-induced paradoxical vocal fold motion disorder (IPVFMD).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary academic referral center.
  
  
  METHODS
  Thirty-four cases that met IPVFMD criteria and 76 cases of non-IPVFMD were selected from a database of patients with paradoxical vocal fold motion disorder-the diagnosis of which was made on the basis of flexible fiberoptic laryngoscopy and augmented by an odor challenge. Clinical charts were reviewed to document history of environmental allergies, pulmonary disease, gastroesophageal reflux, psychiatric disorder, fibromyalgia, tobacco use, alcohol use, dysphonia, cough, dysphagia, and treatment outcomes.
  
  
  RESULTS
  There were no statistical differences between the IPVFMD and non-IPVFMD groups. Of the patients who were assigned and attended laryngeal control therapy, 13 (65%) reported improvement of symptoms. Symptom improvement increased to 100% in those patients who attended at least 2 laryngeal control therapy sessions.
  
  
  CONCLUSIONS
  IPVFMD should be considered in patients presenting with respiratory symptoms after irritant exposure. Sensitivity of diagnosis can be improved via a standardized approach consisting of a careful history and physical examination, including laryngoscopy in the presence of triggers. Laryngeal control therapy is a well-tolerated and effective method of managing IPVFMD.
authors: Department of Otolaryngology, Group Health, Cincinnati, Ohio, USA.
authors: Anna M
authors: AM
authors: Marcinow
authors: Department of Speech and Language Pathology, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA.
authors: Jennifer
authors: J
authors: Thompson
authors: Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA.
authors: L Arick
authors: LA
authors: Forrest
authors: Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA Brad.DeSilva@osumc.edu.
authors: Brad W
authors: BW
authors: deSilva
mesh_terms: D000328:Adult; D000368:Aged; D019992:Databases as Topic; D005260:Female; D006801:Humans; D007509:Irritants; D007828:Laryngoscopy; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D064706:Vocal Cord Dysfunction / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
chemical_list: D007509:Irritants
keywords: dyspnea; irritant induced; laryngeal control therapy; paradoxical vocal fold dysfunction