What is Paradoxical Vocal Fold Movement (also called Vocal Cord Dysfunction)?

Paradoxical vocal fold movement (PVFM) is a disorder of the larynx (voice box) whereby the vocal folds involuntarily close during inspiration (although it can occur during expiration). Symptoms include: dyspnea (shortness of breath), stridor, cough, choking and tightness in the throat. These symptoms can range from mild breathing discomfort to severe respiratory distress. Understandably, severe episodes of PVFM can lead to anxiety and panic. 

Unfortunately, PVFM can be difficult to diagnose as symptoms are episodic and may not be captured during an evaluation. In addition, misdiagnosis and consequential delay in diagnosis is common because PVFM has a similar clinical presentation to other health conditions including: asthma, chronic obstructive pulmonary disease, anaphylaxis, spasmodic dysphonia, vocal fold paralysis and anxiety/panic disorders. Research shows that the average time from symptom onset to diagnosis of PVFM, is greater than 4 years.

The cause of PVFM is unknown; however, current theories suggest that it is related to laryngeal hyper-responsiveness. Triggers of laryngeal hyper-responsiveness may include: upper respiratory tract infection, allergies, reflux, physical exertion, coughing and chemicals/pollutants. Overtime, individuals may develop an inappropriate learned behaviour of vocal fold closure in the presence of any form of irritation to the larynx.

Treatment

PVFM does not respond to medical treatment. Speech Pathology management of PVFM focuses on learning specific breathing and laryngeal exercises in order to regain control over breathing and establish a sense of respiratory ease. If you are looking for treatment for PVFM please contact us to book an appointment with our Speech Pathologist.