Paradoxical Vocal Fold Movement

During normal breathing, your vocal cords remain open so air can freely pass through your windpipe. In paradoxical vocal fold movement (PVFM), also called vocal cord dysfunction or laryngospasms, the vocal folds close while breathing.

Symptoms of Paradoxical Vocal Fold Movement

The symptoms of PVFM may include the following:

  • Shortness of breath (dyspnea)
  • Noisy breathing (stridor)
  • Throat closing sensation
  • Inability to inhale (or, occasionally, to exhale)

Symptoms are often confused with the wheezing that can accompany an upper respiratory infection or asthma.

Fortunately, PVFM is not life-threatening. Although shortness of breath can be scary and make people feel like they may pass out, the body will almost always relax before passing out. In the unlikely event that a person does pass out, the vocal folds will immediately relax, letting air into the lungs.

Causes of Paradoxical Vocal Fold Movement

The cause of PVFM is unknown. It usually starts with short episodes and can be triggered by exercise, smells, or certain foods. However, some people experience PVFM without any triggers. Other factors, such as acid reflux and stress, may contribute to PVFM.

Diagnosing Paradoxical Vocal Fold Movement

In addition to taking a medical history and performing a physical exam, your doctor may use several tests to diagnose PVFM, including the following:

  • Pulmonary function testing: A patient breathes into a machine called a spirometer, which measures how much air they can breathe out or take in.
  • Laryngoscopy: There are two ways of performing this procedure: For indirect laryngoscopy, a small, long-handled mirror is inserted into the throat to see parts of the larynx. For direct laryngoscopy, an instrument called a laryngoscope (a narrow, lighted tube) is inserted through the nose or mouth to get a better view of the area than the indirect laryngoscopy.

PVFM can happen along with asthma or other respiratory issues, so it is important to have a proper pulmonary work-up. Although PVFM is not life-threatening, asthma and other pulmonary diseases can be if not treated.

Treatment for Paradoxical Vocal Fold Movement

Treatment for PVFM is often successful. Therapy focuses on using behavioral techniques and respiratory retraining to restore normal breathing. For some patients, behavioral therapy may need to be coupled with reflux medication and psychological intervention.

Why Choose Columbia

Our specialists use an interdisciplinary approach to treat all conditions affecting the voice, swallowing, and breathing. At your first visit, our team provides a comprehensive medical and behavioral evaluation. Patients are also evaluated simultaneously by laryngologists, speech-language pathologists, and other providers, as needed. Our experts work together to reach the right diagnosis and develop a care plan personalized to your needs.