Unusual presentation of episodic inspiratory stridor "paradoxical vocal fold motion" its awareness and management

Back Ground: stridor is always terrifying entity and presentation of such patient in clinic is Dire emergency. Majority of these cases are dealt with empirical medicines like steroids and antihistamines, but sometimgs patients need surgical intervention like Tracheostomy or Endotracheal intubation to save the life. Paradoxical Vocal Fold motion is a relatively uncommon in routine Otolaryngological practice. So it can be easily confused with Bronchial Asthma or upper air way obstruction like Laryngeal oedema. Due to rare occyrrence and requirement of special diagnostic fiber optic instruments, the final diagnosis can be difficult. Management of paradoxical Vocal Fold Motion is discussed in this original article. Common mistake which is being done by many Otolaryngologists is treatment with Steroids which may worsen the disease. The aim of this study is to increase the awareness about Paradoxical Vocal Fold Motion regarding management with review of literature

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Aim: aim of study is to document the etiological factors and treatment modalities of patients presenting with inspiratory stridor in Paradoxical vocal card motion

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Setting and design: retrospective study in two teaching Hospitals

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Material and methods: records of patients presenting with inspiratory stridor at outpatient and in emergency between 2007 and 2010 were analyzed

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Results: paradoxical vocal fold motion constitutes 77% of inspiratory stridors. Male to female ratio was 1:2.4. Among the etiological factors were sinusitits, allergic Rhinitis, Gastro esophageal reflux disease, Psychogenic and exposure to irritants. Conservative treatment was sufficient in all of these cases, none of these patients required intubation or tracheostomy