Movimiento paradójico de las cuerdas vocales: un estudio de caso / Paradoxical vocal fold motion: a case report

El movimiento paradójico de las cuerdas vocales (MPCV) es un trastorno caracterizado por una inapropiada, involuntaria y paradójica aducción de las cuerdas vocales y bandas ventriculares durante la inspiración, y en casos severos se puede presentar como una obstrucción de las vías respiratorias. Este trastorno se asocia con múltiples etiología tales como reflujo gastroesofágico, trastornos neurológicos periféricos, o centrales, asma y trastornos psicógenos. En el presente artículo se reporta el caso de un niño que presenta tos que había sido tratado inicialmente por asma sin resultados positivos. El examen de fibroscopía flexible revela un cuadro severo de MPCV. Este caso fue tratado con medicación por reflujo, entrenamiento respiratorio y relajación orofaríngea. Se enfatizó el trabajo multidisciplinario con el laringólogo, fonoaudiólogo y orientación psicológica. Revisión de la literatura es discutida.

Paradoxical Vocal Fold Motion (PVFM) is a disorder characterized by inappropriate and involuntary paradoxical vocal folds adduction and ventricular bans during inspiration. In severe cases PVFM is manifested as airway obstruction. This disorder is associated with multiple etiologies such as gastroesophageal reflux, peripheral or central neurological disorders, psychogenic disorders and asthma. In this paper, we report a case of a child who presents cough. He had been treated initially for asthma without positive results. Flexible laryngoscopy revealed severe PVFM. This case was treated with reflux medication, breathing training and oropharyngeal relaxation. It was emphasized a multidisciplinary approach with the laryngologist, voice pathologist and counselling. Review of the literature is discussed.

Paradoxical movement of vocal cords in guillain – barre syndrome: Report a case and review of the literature.

This is a report of a 50 year-old Thai male who was admitted to Siriraj hospital because of progressive weakness of all extremities and increase shortness of breath. Endotracheal tube intubation was introduced for ventilatory support and secretion clearance. The diagnosis of Guillain-Barre syndrome was made based on typical presentation and CSF finding. The patient responsed well to intravenous immunoglobulin with successful extubation but developed upper airway obstruction from paradoxical movement of vocal cords which resolved in 5 days later. The review of the literature was done.

Unilateral Blepharoptosis Associated with Paradoxical Movement on Abduction

PURPOSE: This case is the first report of unilateral ptosis associated with paradoxical movement on abduction in Korean literature and we report this case with a successful result of operations. METHODS: We examined an 18-year-old male patient who had showed drooping of right eyelid since birth. The ptosis was exaggerated on abduction. He did not have any remarkable history of illness. Corrected visual acuity was 20/20 in both eyes. Ocular motility examination revealed full range of ductions and versions in all fields of gaze. On exophthalmometric examination, no difference was found in any direction of gaze between two eyes. Under the diagnosis of unilateral ptosis associated with paradoxical movement on abduction, levator resection of right upper lid and blepharoplasty of left upper lid were performed. RESULTS: During operation, we noticed unusual finding that thickened tendon sheath was covering the lateral one third of levator aponeurosis. Paradoxical eyelid movement disappeared completely after secondary operation by removal of the previously noticed tendon sheath as much as possible.

Two Cases of Paradoxical Vocal Fold Movement / 대한이비인후과학회지

Paradoxical vocal fold movement (PVFM) is a rare disease characterized by the adduction of vocal folds during inspiration. Since patients with PVFM may suffer from acute airway distress or inappropriate treatment for a long period of time, proper diagnosis by the otolaryngologist is critical to proper management. Case 1 was treated with voice therapy which involved self-awarness about what was happening inside his larynx during inspiration, the use of diaphragmatic breathing and laryngeal muscle tension reduction. Case 2 could not be treated with the initial voice therapy but the botulium toxin injection which was used as the second treatment option proved be successful.