Vocal Fold Dysfunction Handout

Diagnostic Features

VCD-PVCM

ASTHMA

Precipitators (triggers)                           Exercise, extreme temperatures, airway irritants, emotional stressors Exercise, extreme temperatures, airway irritants, emotional stressors, allergens
Number of triggers Usually one Usually multiple
Breathing obstruction location Laryngeal area Chest area
Timing of breathing Noises Stridor on inspiration Wheezing on exhalation
Pattern of dyspneic event period Sudden onset and relatively rapid cessation More gradual onset and  longer recovery
Nocturnal awakeningwith symptoms Rarely Almost always
Response to broncho- dilators and/or systemic corticosteroids No response Good response
Flow-volume loop Inspiratory cut-off, perhaps some expiratory limb reduction * Reduced expiratory  limb only
Bronchial provocation test Negative Positive
Laryngoscopic observartions Inspiratory adduction of anterior 2/3 of vocal folds; posterior diamond-shaped chink; perhaps medialization of ventricular folds; inspiratory adduction may carry over to expiration Vocal folds may ad-duct during exhalation
* When patient is symptomatic
Adapted from the following journal article:
Barbara A. Mathers-Schmidt. (2001). Paradoxical Vocal Fold Motion (PVFM):.
A Tutorial on a Complex Disorder and the Speech-Language Pathologist’s Role.
American Journal of Speech-Language Pathology, Volume 10, issue 2, pages 111-125