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The Association between Paradoxical Vocal Fold Motion and Dysphonia in Adolescents.
Folia Phoniatr Logop. 2020; 72(5):378-388.FP

Abstract

OBJECTIVE

Associations between dysphonia and paradoxical vocal fold motion (PVFM) have been previously reported in adults, but it is unclear whether similar associations exist for adolescents. The goals of this study were to identify the prevalence and severity of voice disorders in adolescent patients with PVFM, identify differences between those with and without clinician-identified dysphonia, and investigate what factors were associated with voice handicap in this population.

METHODS

A retrospective review of eligible adolescent patients diagnosed with PVFM over a 1-year period at a single institution was undertaken. Data collected from the medical record included demographic background, medical history and workup, patient- and family-reported symptoms, and findings from the laryngeal examination. The presence or absence of clinician-diagnosed dysphonia was used to subdivide the sample for analysis.

RESULTS

Forty-eight patients with PVFM were included. The sample was primarily female (73%) with a median age of 15 years. Few patients had voice complaints (5%), but clinician-diagnosed dysphonia was common (52%) and ranged from mild to moderate. Vocal hyperfunction was frequently observed (55%), but anatomic abnormalities associated with dysphonia were rare (6%). Adolescents with dysphonia were significantly older, more likely to have vocal hyperfunction on laryngoscopy, and more likely to return for therapy than those without dysphonia. No notable differences existed in the number of behavioral therapy sessions or in the likelihood of completing treatment between the two groups. The majority of participants (79%) had at least one "confounding factor" (i.e., were currently taking a medication for asthma, allergies, or reflux, or had a laryngeal abnormality) but this did not differ significantly between those with and without dysphonia. A minority of individuals (28%) had abnormal scores on the Voice Handicap Index (VHI). Age was positively correlated with dysphonia severity but no other significant associations were observed.

CONCLUSION

Although voice complaints are rare, dysphonia among adolescents with PVFM is common and can occur in the absence of laryngeal abnormalities and medical comorbidities, typically as a result of vocal hyperfunction. Dysphonia does not appear to be a barrier to PVFM treatment and may be a useful target in therapy.

Authors+Show Affiliations

NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA, palmeran@ohsu.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31896115

Citation

Fulton, Nicole M., et al. "The Association Between Paradoxical Vocal Fold Motion and Dysphonia in Adolescents." Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (IALP), vol. 72, no. 5, 2020, pp. 378-388.
Fulton NM, Drake K, Childes JM, et al. The Association between Paradoxical Vocal Fold Motion and Dysphonia in Adolescents. Folia Phoniatr Logop. 2020;72(5):378-388.
Fulton, N. M., Drake, K., Childes, J. M., Ziegler, A., Schindler, J. S., Graville, D. J., & Palmer, A. D. (2020). The Association between Paradoxical Vocal Fold Motion and Dysphonia in Adolescents. Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (IALP), 72(5), 378-388. https://doi.org/10.1159/000502543
Fulton NM, et al. The Association Between Paradoxical Vocal Fold Motion and Dysphonia in Adolescents. Folia Phoniatr Logop. 2020;72(5):378-388. PubMed PMID: 31896115.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Association between Paradoxical Vocal Fold Motion and Dysphonia in Adolescents. AU - Fulton,Nicole M, AU - Drake,Karen, AU - Childes,Jana M, AU - Ziegler,Aaron, AU - Schindler,Joshua S, AU - Graville,Donna J, AU - Palmer,Andrew D, Y1 - 2020/01/02/ PY - 2019/04/21/received PY - 2019/08/06/accepted PY - 2020/1/3/pubmed PY - 2020/1/3/medline PY - 2020/1/3/entrez KW - Adolescents KW - Dysphonia KW - Paradoxical vocal fold motion KW - Respiration KW - Speech-language pathology KW - Vocal cord dysfunction SP - 378 EP - 388 JF - Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) JO - Folia Phoniatr Logop VL - 72 IS - 5 N2 - OBJECTIVE: Associations between dysphonia and paradoxical vocal fold motion (PVFM) have been previously reported in adults, but it is unclear whether similar associations exist for adolescents. The goals of this study were to identify the prevalence and severity of voice disorders in adolescent patients with PVFM, identify differences between those with and without clinician-identified dysphonia, and investigate what factors were associated with voice handicap in this population. METHODS: A retrospective review of eligible adolescent patients diagnosed with PVFM over a 1-year period at a single institution was undertaken. Data collected from the medical record included demographic background, medical history and workup, patient- and family-reported symptoms, and findings from the laryngeal examination. The presence or absence of clinician-diagnosed dysphonia was used to subdivide the sample for analysis. RESULTS: Forty-eight patients with PVFM were included. The sample was primarily female (73%) with a median age of 15 years. Few patients had voice complaints (5%), but clinician-diagnosed dysphonia was common (52%) and ranged from mild to moderate. Vocal hyperfunction was frequently observed (55%), but anatomic abnormalities associated with dysphonia were rare (6%). Adolescents with dysphonia were significantly older, more likely to have vocal hyperfunction on laryngoscopy, and more likely to return for therapy than those without dysphonia. No notable differences existed in the number of behavioral therapy sessions or in the likelihood of completing treatment between the two groups. The majority of participants (79%) had at least one "confounding factor" (i.e., were currently taking a medication for asthma, allergies, or reflux, or had a laryngeal abnormality) but this did not differ significantly between those with and without dysphonia. A minority of individuals (28%) had abnormal scores on the Voice Handicap Index (VHI). Age was positively correlated with dysphonia severity but no other significant associations were observed. CONCLUSION: Although voice complaints are rare, dysphonia among adolescents with PVFM is common and can occur in the absence of laryngeal abnormalities and medical comorbidities, typically as a result of vocal hyperfunction. Dysphonia does not appear to be a barrier to PVFM treatment and may be a useful target in therapy. SN - 1421-9972 UR - https://www.unboundmedicine.com/medline/citation/31896115/The_Association_between_Paradoxical_Vocal_Fold_Motion_and_Dysphonia_in_Adolescents_ L2 - https://www.karger.com?DOI=10.1159/000502543 DB - PRIME DP - Unbound Medicine ER -
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