Does treatment of paradoxical vocal fold movement disorder decrease asthma medication use?

Laryngoscope. 2017 Jul;127(7):1531-1537. doi: 10.1002/lary.26416. Epub 2016 Nov 15.

Abstract

Objectives/hypothesis: To determine whether diagnosis and treatment of paradoxical vocal fold movement disorder (PVFMD) leads to decreased asthma medication use. Secondary objectives include determining initial rate of asthma medication use, characterizing symptom improvement, and correlating with pulmonary function testing (PFT).

Study design: Prospective observational study.

Methods: Patients newly diagnosed with PVFMD at a single institution were recruited to participate. Medication questionnaires were completed at the initial visit, at the first return visit for therapy, and at 6 months. PFTs were reviewed when available.

Results: Sixty-six patients were recruited; the study was closed early because findings reached significance. Fifty-six patients (85%) were taking asthma medication at presentation. Forty-four patients presented with PFTs, and two-thirds were normal. Forty-two patients completed follow-up questionnaires; 79% decreased asthma medication use (P < .001), and 82% reported symptom improvement. Seventy-seven percent of patients participated in therapy and 23% did not, with equal rates of decrease in asthma medication use between these groups. Outcomes did not vary based on PFT pattern (i.e., obstructive vs. nonobstructive, P = .75).

Conclusions: Diagnosis and treatment of PVFMD lead to a decline in asthma medication use. This decrease occurred alongside symptom improvement and irrespective of PFT findings. Use of asthma medication in this patient population is high, at 85%.

Level of evidence: 4. Laryngoscope, 127:1531-1537, 2017.

Keywords: Paradoxical vocal fold movement; asthma; vocal cord dysfunction.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / etiology*
  • Asthma / therapy*
  • Child
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngoscopy
  • Male
  • Middle Aged
  • Patient Education as Topic*
  • Prospective Studies
  • Speech Therapy*
  • Speech-Language Pathology / methods
  • Statistics as Topic
  • Symptom Assessment*
  • Vocal Cord Dysfunction / diagnosis*
  • Vocal Cord Dysfunction / surgery*
  • Young Adult

Substances

  • Anti-Asthmatic Agents