Paradoxical Vocal Cord Motion

Paradoxical vocal cord motion is defined by an inappropriate adduction of the true vocal cords on inspiration and adduction on expiration. The functional airway obstruction results in marked inspiratory stridor and wheezing, and the symptoms are similar to asthma. Often misdiagnosed as refractory asthma, paradoxical vocal cord motion appears to be psychogenic and occurs most often in young women with a history of prior psychiatric illnesses (e.g., depression, personality disorder, posttraumatic stress disorder, sexual abuse, generalized anxiety). Diagnosis is made by direct laryngoscopy with visualization of the cords throughout the respiratory cycle. Treatment is difficult because there are no published studies on the efficacy of psychodynamic therapy or pharmacologic treatment.

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