Paradoxical Vocal Fold Movement (PVFM)

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WHAT IS VOCAL CORD DYSFUNCTION? Vocal cord dysfunction abbreviated as VCD is also known as “Paradoxical Vocal Fold Movement (PVFM)” or “Paradoxical Vocal Fold Motion (PVFM)” or “Laryngospasms“. Doctors dealing with the ear, throat, and nose (otolaryngologist) term this disorder as “Paradoxical Vocal Fold Motion Disorder (PVFMD)” while pulmonologists that deal with the lungs term […] Read More

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Paradoxical Vocal Fold Movement (PVFM)

WHAT IS VOCAL CORD DYSFUNCTION? Vocal cord dysfunction abbreviated as VCD is also known as “Paradoxical Vocal Fold Movement (PVFM)” or “Paradoxical Vocal Fold Motion (PVFM)” or “Laryngospasms“. Doctors dealing with the ear, throat, and nose (otolaryngologist) term this disorder as “Paradoxical Vocal Fold Motion Disorder (PVFMD)” while pulmonologists that deal with the lungs term the disorder as “Vocal Cord Dysfunction (VCD)“. But they all mean the same thing and they can be used interchangeably. The paradoxical vocal fold is experienced when the voice box consisting of the vocal cords does not open up properly. Most times the vocal dysfunction can be mistaken with asthma due to the similarities in the symptoms experienced by both conditions.  In the paradoxical vocal cord dysfunction, the vocal fold closes instead of opening while trying to breathe. When this happens, a high-pitched sound comes out when breathing in which is known as an “Inspiratory Stridor” resulting in shortness of breath and affects the speech.  The difference between the vocal cord spasm and asthma is that for the asthmatic situation, the bronchial tubes consisting of the airway contracts resulting in difficulty in breathing and is also associated with gene and immune system while the paradoxical vocal cord dysfunction is said to be a non-allergic situation that is acquainted with the immune system. Also, the VCD increases difficulties in breathing in than breathing out while the case is reverse for patients with asthma which is a clear indication of the symptom differences. In most cases, persons diagnosed with asthma also end up having vocal dysfunction. Both cases possess similar symptoms and triggers but the VCD treatment varies greatly from that used for regulating and managing asthma.   Therefore, proper VCD diagnosis must be strictly conducted for efficient results indicating the disparities between asthma and vocal cord dysfunction. An immunologist or allergist is responsible for conducting this diagnosis as professionalism is required for efficiency. VOCAL CORD DYSFUNCTION DIAGNOSIS Different doctors can conduct the process, a pulmonologist, gastroenterologist, allergist, neurologist, otolaryngologist, or a psychologist.  People with PVFM possess varying symptoms complicating the chances of diagnosing the VCD. Therefore, measures adhered to for conducting diagnosis are:
  • Patient History
The medical history of the patient is to be crosschecked for previous medications taken, lung condition, smoking habit, previous and current symptoms to pinpoint the main determinant of the diagnosis of the VCD.
  • Pulmonary Function Testing
This is a typical form of testing for patients with the paradoxical vocal fold motion disorder as it is used to rule out a condition acquainted with pulmonary diseases. This is done due to the association of breathing problems with pulmonary diseases. The identification of any lung disease associated with the condition is mandatory for easy recommendations of treatment that would be effective for the patient.
  • Laryngoscopy
In this case, the doctor examines the vocal folds with the aid of a tube known as an endoscope which is passed through the nose or mouth alongside a stroboscope which is a flashing light that enhances the view of the vocal fold movement when talking or breathing. This movement can be triggered by providing a patient a strong odor and observe the responses by the vocal fold.
  • Investigation of Irritants
Factors like allergies, acid reflux, and stress are monitored in this case. VOCAL CORD DYSFUNCTION TREATMENT The aim to be achieved by the treatment is to ensure that the vocal fold opens well and remains open while breathing, thereby, becoming fully effective. The patient will also need to take into consideration the factors that trigger the VCD, therefore abstaining from those triggers. Patients suffering from VCD as a result of emotional stress are recommended to consult a therapist to proffer VCD therapy. Generally, the SLP is the best medical professional for the PVFM as they can give exercises that help. The treatment plan for patients with vocal cord spasm can also be used for managing patients with asthma as they both occur together most times. Treatment plans that could aid recovery from the vocal cord dysfunction are;
  • Respiratory Training
Respiratory training is said to be a vocal cord dysfunction exercise. It involves series of vocal cord dysfunction breathing exercises for the restoration of the effective opening of the vocal fold. The Speech-Language Pathologist (SLP) helps in developing throat relaxation and forms of breathing to curb the paradoxical vocal fold dysfunction. These breathing exercises are developed based on the needs of the patient and are geared to tackle some specific triggers for different patients.
  • Reflux Medication
The reflux medication can be considered as a vocal cord dysfunction home remedy whereby acid reflux is tackled. In this case, the acid reflux is limited to null the reaction of the vocal fold to the protective mechanism. Therefore, medications are taken to effect this and further examination is to be conducted by a gastrointestinal specialist in cases where the symptoms are persistent.

Symptoms

VOCAL CORD DYSFUNCTION SYMPTOMS

The most indicating symptom of vocal dysfunction is difficulty in breathing through the symptoms range from mild to severe cases. Another symptom is constrictions in the throat region.

Symptoms that can be experienced with vocal cord dysfunction are:

  1. Tightness in the throat.
  2. Difficulty in breathing in.
  3. Feeling light-headed.
  4. Inspiratory stridor i.e noise as a result of inhalation.
  5. Feeling of breathing through a straw.
  6. Loud breaths.
  7. Coughing.
  8. Sudden loss of voice.

    Causes

    VOCAL CORD DYSFUNCTION CAUSES

    Paradoxical vocal cord dysfunction is attributed mostly to stress mostly before a performance or a competition and the vocal folds have been strained and stressed. This is because there is no particular cause of the paradoxical vocal fold movement.

    It can last for several minutes or even hours depending but it can also lead to fainting due to the inadequacy of air through the airways to the voice box. This disorder is not life-threatening and the action is said to be passive i.e involuntary action.

    When a patient faints, the vocal folds tend to spread open and the vocal cord spasm relaxes permitting the inflow of air that passes through from the trachea down to the lungs.

    Another possible cause or trigger of the vocal cord attack is acid reflux. When the acid reflux in the system is strong enough to get to the throat, it can lead to an irritation in the vocal cord triggering a closure as a means of protecting it. Therefore, this protection mechanism results in a possible VCD attack.

    Other possible causes of the PVFM are:

    1. Breathing in cold air.
    2. Emotional stress.
    3. Inhalation of lung irritants
    4. Exercise. 
    5. Smoking.
    6. Viral infection.
    7. Gastroesophageal Reflux Disease (GERD).

    FAQ

    • How do you stop a VCD?

    The speech therapy administered by the speech-language pathologist is the best treatment for vocal cord dysfunction as breathing exercises and voice training will be done.

    • How do you lubricate vocal cords?

    The best way of lubricating the vocal cord is by keeping hydrated always. It is recommended that a person should drink 64 ounces of water per day. This volume produces thin and watery mucus.

    • How do I relax my vocal cords?

    Placing the hands on the chest and massaging the surface then raising the chin and rubbing the chin back and forth for 20 seconds.

    • How can I speak without straining my vocal cords?

    Deep breaths from the chest are used to support the voice especially in singers and speakers who minister or speak regularly. Therefore, deep breaths help in reducing strains in the vocal cord.

    • How do I stop vocal fatigue?

    Resting the vocals and hydration is the best way to prevent and stop fatigue in the vocals.