• The Laryngoscope · Jun 2014

    Comparative Study

    Paradoxical vocal fold motion disorder in the elite athlete: experience at a large division I university.

    • Anna M Marcinow, Jennifer Thompson, Tendy Chiang, L Arick Forrest, and Brad W deSilva.
    • Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.
    • Laryngoscope. 2014 Jun 1; 124 (6): 1425-30.

    Objectives/HypothesisTo review our experience at a large division I university with the diagnosis and management of paradoxical vocal fold motion disorder (PVFMD) in elite athletes.Study DesignA single institution retrospective review and cohort analysis.MethodsAll elite athletes (division I collegiate athletes, triathletes, and marathon runners) with a diagnosis of PVFMD were identified. All patients underwent flexible fiberoptic laryngoscopy (FFL) to confirm the diagnosis of PVFMD. The type of PVFMD therapy was identified and efficacy of treatment was graded based on symptom resolution.ResultsForty-six consecutive athletes with PVFMD were identified. A total of 30/46 (65%) were division 1 collegiate athletes and 16/46 (35%) were triathletes or marathon runners. In comparison to a nonathlete PVFMD cohort, athletes were less likely to present with a history of reflux (P < 0.01), psychiatric diagnosis (P < 0.01), dysphonia (P < 0.01), cough (P = 0.02), or dysphagia (P < 0.01). The use of postexertion FFL provided additional diagnostic information in 11 (24%) patients. Laryngeal control therapy (LCT) was recommended for 45/46. A total of 36/45 attended at least one LCT session and 25 (69%) reported improvement of symptoms. Additionally, biofeedback, practice-observed therapy, and thyroarytenoid muscle botulinum toxin injection were required in three, two, and two patients, respectively.ConclusionThe addition of postexertion FFL improves the sensitivity to detect PVFMD in athletes. PVFMD in athletes responds well to LCT. However, biofeedback, practice-observed therapy, and botulinum toxin injection may be required for those patients with an inadequate response to therapy.Level Of Evidence4.© 2013 The American Laryngological, Rhinological and Otological Society, Inc.

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