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Paradoxical VFM
Paradoxical Vocal Fold Motion
| Question | Answer |
|---|---|
| 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
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