Paradoxical vocal fold movement: diagnosis and management

Paradoxical vocal fold dysfunction (PVFD) is one of many terms used to describe disorders of the upper airway where vocal folds do not present normal patterns during respiration, leading to significant respiratory distress. When symptomatic, patients show varying vocal fold patterns of closure during inspiration, expiration, or combinations of both. Constriction of supraglottic structures also may occur. The airway obstruction can result in life-threatening Emergency Room presentation, leading to intubation and even tracheostomy. Although PVFD affects few patients overall, 10% of those diagnosed with asthma may have PVFD alone or in combination with asthma. Correct diagnosis and treatment are vital to avoid costly and even unnecessary medications and hospitalizations.