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The forgotten cause of stridor in the emergency department

Authors Ng TT

Received 24 October 2016

Accepted for publication 16 December 2016

Published 16 January 2017 Volume 2017:9 Pages 19—22


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Hans-Christoph Pape

Tian-Tee Ng

Ear, Nose and Throat Unit, Department of Surgery, Frankston Hospital, Peninsula Health, Frankston, VIC, Australia

Abstract: Paradoxical Vocal Fold Movement Disorder is where the larynx exhibits paradoxical vocal cords closure during respiration, creating partial airway obstruction. Causes of vocal fold movement disorder are multifactorial, and patients describe tightness of throat, difficulty getting air in, have stridor, and do not respond to inhalers. We propose using transnasal laryngoscopy examination, which will show narrowing of vocal cords on inspiration, and The Pittsburgh Vocal Cord Dysfunction Index with a cutoff score of ≥4 to distinguish vocal fold movement disorder from asthma and other causes of stridor. Management of paradoxical vocal fold movement disorder involves a combination of pharmacological, psychological, psychiatric, and speech training. Paradoxical vocal fold movement disorder is a very treatable cause of stridor, so long as it is identified and other organic causes are excluded.

Keywords: paradoxical vocal fold movement disorder, stridor, emergency

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