1/18. Paradoxical vocal cord motion causing stridor after thyroidectomy.Two women developed stridor immediately after thyroidectomy as a result of paradoxical vocal cord motion. In both cases the cord function showed a normal pattern during vocalisation but paradoxical movement was seen at laryngoscopy during tidal breathing. The abnormality improved in both patients over time with speech therapy. Whilst the syndrome of paradoxical vocal cord motion is classically thought to have a largely psychological aetiology, subtle interference with laryngeal innervation at surgery is more likely to have been the cause in these cases.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/18. Respiratory stridor and repressive defense style in adolescent somatoform disorders.Three cases of adolescents with respiratory stridor of psychiatric etiology are described. All three fulfilled DSM-III-R criteria for diagnoses of somatoform disorders and showed characteristics of repressive defense style. Such patients are likely to undergo extensive medical investigation and treatment if the psychiatric nature of their disorder is not recognized, but few data describing their psychological characteristics or treatment exist. Repressors are typically unaware of emotional arousal and do not recognize the negative affects which lead to their somatic symptoms. They therefore respond poorly to confrontational psychotherapy and are at risk of discontinuing treatment and repeating their maladaptive symptom cycle. Identification of repressive defense style in patients with stridor which has no obvious organic cause may be useful both as a possible "marker" of psychiatric disorder and as a guide to treatment.- - - - - - - - - - ranking = 0.16666666666667keywords = motion (Clic here for more details about this article) |
3/18. Paradoxical vocal cord motion: an often misdiagnosed cause of postoperative stridor.This conference reports a case of acute functional airway obstruction occurring in the postoperative anesthesia care unit, which was diagnosed by fiberoptic laryngoscopy and successfully treated with intravenous midazolam after other more common causes of stridor were ruled out. The presentation, etiology, diagnosis, and treatment of paradoxical vocal cord motion as it relates to the care of the postoperative patient are discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = motion (Clic here for more details about this article) |
4/18. eucalyptus as a specific irritant causing vocal cord dysfunction.BACKGROUND: vocal cord dysfunction (VCD) is a well-recognized clinical entity that frequently mimics asthma and is characterized by inappropriate adduction of the vocal cords during inspiration. The pathogenesis of VCD has not yet been defined. The only previous report suggested that respiratory irritants may trigger paradoxical motion of the vocal cords. OBJECTIVE: To report the case of a 46-year-old woman with VCD precipitated by eucalyptus exposure. methods: A masked flexible fiberoptic nasolaryngoscopy was performed to confirm whether VCD occurred with eucalyptus and not with other known respiratory irritants. The patient underwent inhalation challenges consisting of water, ammonia, pine oil, and a combination of eucalyptus (dried leaves) and ammonia. Two independent observers before patient challenge could not identify eucalyptus. RESULTS: Vocal cord dysfunction occurred within minutes of exposure to eucalyptus. This is the first report to prospectively document that a specific irritant, eucalyptus, can precipitate VCD. Negative skin prick test results, total IgE level, and negative IgE eucalyptus-specific antibodies support a nonimmunologic mechanism. CONCLUSIONS: A new pathogenic mechanism for this clinical entity is supported by our observations. Furthermore, a nonimmunologic mechanism in which respiratory irritants may induce VCD is suspected. Future studies to elucidate this mechanism need to be performed in individuals with irritant-specific VCD.- - - - - - - - - - ranking = 0.16666666666667keywords = motion (Clic here for more details about this article) |
5/18. Functional stridor diagnosed by the anaesthetist.While stridor is an ominous sign implying severe airway stenosis, not all stridor has an organic aetiology. We present two cases of functional stridor in which the diagnosis was made by the anaesthetist. As experts in the management of difficult airways, anaesthetists should be aware of this clinical entity. Recurrent episodes present as aphonia, dysphonia, dyspnoea, apnoea or unconsciousness. Stridor is usually inspiratory. Flow volume loops show a pattern of variable extrathoracic obstruction with diminished peak inspiratory flow. Awake fibreoptic laryngobronchoscopy reveals normal airway anatomy, intense adduction of false and true vocal cords during inspiration and normal vocal cord motion on expiration. Treatment of functional stridor is supportive. The diagnosis of functional stridor demands exclusion of life-threatening airway stenosis of organic aetiology. A high index of suspicion for this clinical entity will reduce the incidence of unnecessary interventions such as tracheal intubation and tracheostomy.- - - - - - - - - - ranking = 0.16666666666667keywords = motion (Clic here for more details about this article) |
6/18. exercise-induced stridor due to abnormal movement of the arytenoid area: videoendoscopic diagnosis and characterization of the "at risk" group.We evaluated 4 patients who developed severe, symptomatic stridor during maximal cardiopulmonary exercise testing, all referred due to exercise-related dyspnea. All underwent resting, unsedated transnasal fiberoptic laryngoscopy and had normal findings. Four patients performed repeat maximal exercise testing with fiberoptic laryngoscopy, and they form the basis of this report. They had normal vocal cord motion during exercise, but developed abnormal anterior motion of the arytenoid and aryepiglottic folds only at peak exercise, leading to partial airway obstruction and severe stridor. This report details the workup and characterizes patients at risk for this unusual phenomenon.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
7/18. Paradoxical vocal cord motion--a case report.Paradoxical vocal cord motion (PVCM) is an unusual cause of stridor, which is associated with some underlying causes, such as central nervous system lesion, gastroesophageal reflux or psychogenic problem. Once a diagnosis of PVCM is made, acute management with reassurance and sedation instead of aggressive airway intervention is required. speech therapy, psychotherapy combination with anti-reflux medication is considered to be useful in long-term management. We present a 58 year-old male patient who had suffered from several episodes of acute onset of stridor, short of breath and tachypnea since one year ago. He was initially treated as an asthmatic patient with poor response. aneurysm of ascending aorta by angiography, and mild gastroesophageal reflux with hiatal hernia by panendoscopy were noted. Then, the paradoxical vocal cord motion during inspiration phase was confirmed by flexible fiberoptic nasopharyngoscope after the consultation with an otolaryngologist. The emergency of his air-hunger was relieved quickly after psychological intervention. Now, he is free of stridor attack under anti-reflux therapy and psychotherapy.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/18. vocal cord dysfunction presenting as bronchial asthma: the association with abnormal thoraco-abdominal wall motion.A 23 year old man with glottic dysfunction presented as recurrent bronchial asthma. His symptoms were aggravated by application of a noseclip and associated with asynchronous thoraco-abdominal wall motion. The glottic dysfunction was corrected by sedation but not continuous positive airway pressure. This is the first report of vocal cord dysfunction triggered by application of a noseclip and associated with asynchronous thoraco-abdominal wall motion.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/18. Paradoxical vocal cord motion: an unusual cause of stridor.Stridor due to obstructive causes is relatively common. Functional airway obstruction with paradoxical vocal cord motion is uncommon. Only 12 cases have been reported in the literature in the past 15 years. The majority were young female patients. We have recently encountered two cases. Lack of awareness of this condition caused several problems in management.- - - - - - - - - - ranking = 0.83333333333333keywords = motion (Clic here for more details about this article) |
10/18. Stridor in an adult. An unusual presentation of functional origin.A 34-year-old woman with a recent history of a influenza-like illness and signs of bronchopneumonia presented with many of the features of acute epiglottitis, a condition which still carries a high mortality in adults. Urgent laryngoscopy and bronchoscopy under inhalational anaesthesia were negative. The results of arterial blood gases, taken when stridor was at its worst, revealed marked hypocapnia and respiratory alkalosis. We conclude that the resultant acute reduction of serum ionised calcium produced stridor as a result of tetany of the vocal cords. Similar cases from the literature and the role of emotional factors in the aetiology are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = motion (Clic here for more details about this article) |
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