Paradoxical vocal fold motion
- Also known as "vocal cord dysfunction"
- Occurs from abnormal adduction of the vocal cords during inspiration
- Lack of familiarity may lead to delayed diagnosis and unnecessary intubation or surgical airway procedures
- Gold standard is laryngoscopy (ideally with flexible fiberoptics)
- Reassurance and breathing techniques to resolve stridor:
- Jaw thrust while breathing
- Pursed lip breathing through straw or endotracheal tube
- Inhale through nose for 3 seconds and exhale through pursed lips for 3 seconds
- "Pant like a dog" - rhythmic breathing with mouth open and tongue protruding forward
- 3 sniffs - take 2 quick then 1 slow inhalational sniffs through the nose, exhale slowly through mouth
- Mild sedatives (eg benzodiazepines) may be effective in cases refractory to breathing techniques
- Denipah N, Dominguez CM, Kraai EP, Kraai TL, Leos P, Braude D. Acute Management of Paradoxical Vocal Fold Motion (Vocal Cord Dysfunction). Annals of Emergency Medicine. 2017;69(1):p18-23.
- Goldman J, Muers M. Vocal cord dysfunction and wheezing. Thorax. 1991;46(6):401-404. doi:10.1136/thx.46.6.401