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Paradoxical vocal cord motion: a review focused on multiple system atrophy.
Auris Nasus Larynx. 2007 Dec; 34(4):443-52.AN

Abstract

OBJECTIVE

Paradoxical vocal cord motion (PVCM) is a well recognized respiratory condition in which active adduction of the vocal cords during inspiration causes functional airway obstruction. It is considered that laryngeal reflex acceleration underlies the generation of nonorganic PVCM. In various situations producing PVCM, multiple system atrophy (MSA) is a representative neurological disease causing nocturnal laryngeal stridor attributed to PVCM. The purpose of this review is to identify the underlying mechanisms associated with nonorganic and MSA-related PVCM. The following issues are addressed in this review: (1) the pathophysiology of nonorganic and MSA-related PVCM, (2) the relationships between PVCM and airway reflexes, and (3) the treatment for MSA-related PVCM.

METHODS

Review.

RESULTS AND CONCLUSIONS

An abnormality of the laryngeal output-feedback control underlies nonorganic PVCM, which is usually triggered by an excessive response to external and internal airway stimuli. Similarly, several clinical and experimental evidence suggest that MSA-related PVCM is attributed to the airway reflex as well as to paradoxical central outputs resulting from the MSA-induced damage to the pontomedullary respiratory center. Application of continuous positive airway pressure (CPAP), which suppresses the reflexive inspiratory activation of adductors, is recommended as the treatment for MSA-related PVCM.

Authors+Show Affiliations

Department of Otolaryngology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba City, Chiba 260-8670, Japan. shibak1963@yahoo.co.jpNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17482397

Citation

Shiba, Keisuke, et al. "Paradoxical Vocal Cord Motion: a Review Focused On Multiple System Atrophy." Auris, Nasus, Larynx, vol. 34, no. 4, 2007, pp. 443-52.
Shiba K, Isono S, Nakazawa K. Paradoxical vocal cord motion: a review focused on multiple system atrophy. Auris Nasus Larynx. 2007;34(4):443-52.
Shiba, K., Isono, S., & Nakazawa, K. (2007). Paradoxical vocal cord motion: a review focused on multiple system atrophy. Auris, Nasus, Larynx, 34(4), 443-52.
Shiba K, Isono S, Nakazawa K. Paradoxical Vocal Cord Motion: a Review Focused On Multiple System Atrophy. Auris Nasus Larynx. 2007;34(4):443-52. PubMed PMID: 17482397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paradoxical vocal cord motion: a review focused on multiple system atrophy. AU - Shiba,Keisuke, AU - Isono,Shiroh, AU - Nakazawa,Ken, Y1 - 2007/05/04/ PY - 2006/05/02/received PY - 2007/02/10/revised PY - 2007/03/14/accepted PY - 2007/5/8/pubmed PY - 2008/3/4/medline PY - 2007/5/8/entrez SP - 443 EP - 52 JF - Auris, nasus, larynx JO - Auris Nasus Larynx VL - 34 IS - 4 N2 - OBJECTIVE: Paradoxical vocal cord motion (PVCM) is a well recognized respiratory condition in which active adduction of the vocal cords during inspiration causes functional airway obstruction. It is considered that laryngeal reflex acceleration underlies the generation of nonorganic PVCM. In various situations producing PVCM, multiple system atrophy (MSA) is a representative neurological disease causing nocturnal laryngeal stridor attributed to PVCM. The purpose of this review is to identify the underlying mechanisms associated with nonorganic and MSA-related PVCM. The following issues are addressed in this review: (1) the pathophysiology of nonorganic and MSA-related PVCM, (2) the relationships between PVCM and airway reflexes, and (3) the treatment for MSA-related PVCM. METHODS: Review. RESULTS AND CONCLUSIONS: An abnormality of the laryngeal output-feedback control underlies nonorganic PVCM, which is usually triggered by an excessive response to external and internal airway stimuli. Similarly, several clinical and experimental evidence suggest that MSA-related PVCM is attributed to the airway reflex as well as to paradoxical central outputs resulting from the MSA-induced damage to the pontomedullary respiratory center. Application of continuous positive airway pressure (CPAP), which suppresses the reflexive inspiratory activation of adductors, is recommended as the treatment for MSA-related PVCM. SN - 0385-8146 UR - https://www.unboundmedicine.com/medline/citation/17482397/Paradoxical_vocal_cord_motion:_a_review_focused_on_multiple_system_atrophy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(07)00052-1 DB - PRIME DP - Unbound Medicine ER -