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Paradoxical VFM

Paradoxical Vocal Fold Motion

QuestionAnswer
Episodic restricted airway opening; vocal fold adduction during inhalation and/or exhalation Paradoxical Vocal Fold Motion (PDFM)
Episodic adductor VF spasms that interfere with breathing Paradoxical Vocal Fold Motion (PDFM)
Likely heterogeneous in etiology and symptoms Paradoxical Vocal Fold Motion (PDFM)
labored breathing Dyspnea
movement in conflict of purpose Paradoxical Vocal Fold Movement
Description of PDFM? 1. dyspnea 2. movement in conflict with purpose 3. choking feeling 4. confused with asthma
Male/Female? Female
Ages? 20-40yrs
Adult Risk Factors 1. High school + 2. Health Care Worker
Child Risk Factors 1. high achievers 2. active in sports
Etiology GERD, Postnasal drip, smoke, gases, vapors, dust, pollutants
Spasmodic dysphonia: A voice disorder caused by involuntary movements of one or more muscles of the larynx or voice box. Chronic laryngeal dystonia
Rare Neurogenic causes brain compression, UMN injury, LMN injury
What MAY play a role in PVFM? Psychological/Psychogenic Factors (stress, anxiety, emotional problems)
What may undermine successful treatment? Stressing psychological issues
Focus on patients...? description of the problem
Occasional dysphonia/dysphasia...? subsequent to upper respiratory infection
Precipitators? exertion, hyperventilation, laughing, hot/cold air, irritants (dust, smoke, odors)
Pulmonary function tests Laryngoscopy and Airway Fluoroscopic Eval.
Laryngoscopy: Adduction during_______ __________. tidal breathing
Laryngoscopy: What is viewed posteriorly? glottal chink
Laryngoscopy: Possible medialization of ___________ ___________. ventricular folds
PVFM must be differentiated from ____________. asthma
What is the first element in MEDICAL TREATMENT? patient education, counseling
In regard to medical treatment it is also suggested that patient terminate any _______________ _________________. unnecessary medications
Medical treatment also consists of treating other _____________ ____________. contributory conditions (GERD, rhinosinusitis)
Medical treatment in RARE, unresponsive cases __________________. tracheostomy
The role of the SLP? Assessment, DX and TX
Need to assess...h__________, f___________ of VF's, r_______________ function for speech, m__________________ tension, OPE for s___________ s_____________. history function respiratory musculoskeletal speech structures
Treatment: Need to identify and control t____________. tension
Inhalation- slow through the nose; exhalation- prolonged /s/ Relaxed throat breathing
Created by: sramsden