Shortness Of Breath In An Athlete - Page #4
 

Working Diagnosis:
Paradoxical Vocal Fold Motion (PVFM)

Treatment:
Bilateral injections of 3.75 MU botox into thyroarytenoid muscles.

Outcome:
Her voice remained severely breathy for 2 weeks and returned to baseline at 4 months after injections. She played the remainder of the soccer season with no issues.

Author's Comments:
It has been speculated the incidence of PVFM may be as high as 3% among collegiate athletes. A prospective evaluation of 167 patients diagnosed with intractable asthma showed that PVFM was the reason for treatment failure in 30% of cases. About one-third of patients exclusively exhibited PVFM; two-thirds suffered from both PVFM and asthma.
Conclusion: A healthcare professional with a high index of suspicion and an understanding of the signs and symptoms of PVFM can appropriately direct treatment.

References:
1.Hartnick C, Boseley M."Paradoxical Vocal Fold Motion." In: Sataloff, RT et al. Pediatric Voice Disorders. Pleural Publishing. 245-256.
2. Newsham KR, Klaben BK, Miller VJ, Saunders JE. Paradoxical vocal cord dysfunction: Management in athletes. J Athl Train 2002 Sept;37(3):325-328
3. Newman KB, Mason UG, Schmaling KB. Clinical features of vocal cord dysfunction. Am J Respir Crit Care Med 1995;152;1382-6
4. Sataloff RT (2005)."Respiratory Dysfunction." Professional voice - The Science and Art of Clinical Care, 3rd ed. Plural Publishing, Inc: San Diego, CA. 717-728

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