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Pulm Pharmacol Ther 2019 Apr 17. Epub 2019 Apr 17.

Department of Respiratory Medicine, Royal Brompton Hospital, London, SW3 6HP, UK. Electronic address:

The larynx is one of the most highly innervated organs in humans, adapted to simultaneously deliver several key respiratory functions including airway protection, swallowing and phonation. In some individuals the larynx can adopt a state that could be considered 'dysfunctional' or maladaptive; resulting in or contributing to a range of clinical disorders such as chronic refractory cough, inducible laryngeal obstruction (previously termed paradoxical vocal fold movement or vocal cord dysfunction), muscle tension dysphonia and globus pharyngeus. These disorders appear to display significant overlap in clinical symptomology and in many cases have features of concomitant or allied sensory dysfunction; often described as laryngeal hypersensitivity. Read More

Clin Exp Allergy 2019 Apr 19. Epub 2019 Apr 19.

Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Idiopathic anaphylaxis (IA) or spontaneous anaphylaxis is a diagnosis of exclusion when no cause can be identified. The exact incidence and prevalence of IA is not known. The clinical manifestations of IA are similar to other known causes of anaphylaxis. Read More

Pulmonology 2019 Apr 15. Epub 2019 Apr 15.

Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

Upper airways (UA) include the nasal cavities, pharynx, and larynx, and its main function is to warm and filter the inspired air. UA dysfunction is in the pathogenesis of various disorders, such as obstructive sleep apnea syndrome (OSAS) and vocal cord dysfunction. In addition, in some neurodegenerative diseases (e. Read More

Respirology 2019 Apr 11. Epub 2019 Apr 11.

Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.

Int Arch Otorhinolaryngol 2019 Apr 24;23(2):125-130. Epub 2018 Oct 24.

Department of ENT, Little Flower Hospital, Ernakulam, Kerala, India.

 Vocal cord dysfunction is characterized by unintentional paradoxical vocal cord movement resulting in abnormal inappropriate adduction, especially during inspiration; this predominantly manifests as unresponsive asthma or unexplained stridor. It is prudent to be well informed about the condition, since the primary presentation may mask other airway disorders.  This descriptive study was intended to analyze presentations of vocal cord dysfunction in a tertiary care referral hospital. Read More

J Allergy Clin Immunol Pract 2019 Mar 30. Epub 2019 Mar 30.

Speech, Language, Hearing Sciences Department, University of Montana, Montana, USA.

Chronic cough is a common, debilitating condition that can persist for years with little relief from medical treatment. Speech pathology treatment is an effective treatment option for patients with chronic cough. This review outlines current speech pathology assessment and treatment for chronic cough and describes the evidence supporting the intervention. Read More

Respirology 2019 Mar 18. Epub 2019 Mar 18.

Monash Lung and Sleep, Monash University and Hospital, Melbourne, Victoria, Australia.

Background And Objective: Multidisciplinary team (MDT) clinics use an integrated approach to individualize care of complex medical conditions. Vocal cord dysfunction (VCD) is a challenging condition that is likely to benefit from MDT clinics but this has not been researched.

Methods: A prospective observational cohort study of a novel VCD MDT clinic was conducted in patients with suspected VCD. Read More

Pediatr Ann 2019 Mar;48(3):e121-e127

Exercise-induced dyspnea in children and adolescents can occur for many reasons. Although asthma is the common cause, failure to prevent exercise-induced asthma by pretreatment with a bronchodilator, such as albuterol, indicates that other etiologies should be considered. Other causes of exercise-induced dyspnea include exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, chest wall restrictive abnormalities, cardiac causes, and normal physiologic limitation. Read More

Laryngoscope 2019 Mar 7. Epub 2019 Mar 7.

Department of Otolaryngology, Westmead Hospital, Westmead, New South Wales, Australia.

Objectives/hypothesis: Unilateral vocal fold paralysis is a structural abnormality that often occurs secondary to dysfunction of the recurrent laryngeal nerve and typically presents as a breathy voice. Medialization laryngoplasty is a constellation of procedures that improves apposition of the vocal cords. Many patients, however, fail to experience sufficient improvement in vocal quality postoperatively despite apparent glottic closure on stroboscopy. Read More

BMJ Open Sport Exerc Med 2019 18;5(1):e000436. Epub 2019 Jan 18.

Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway.

Background: Exercise-induced laryngeal obstruction (EILO) is common in athletes and presents with dyspnoea, chest tightness, inspiratory stridor and sometimes panic reactions. The evidence for conservative treatment is weak, but case reports suggest effects from inspiratory muscle training (IMT). We aimed to explore effects from IMT used in athletes with EILO. Read More

Disabil Rehabil 2019 Jan 29:1-10. Epub 2019 Jan 29.

b Speech Pathology, Faculty of Health Sciences , The University of Sydney , Australia.

Purpose: Oropharyngeal dysphagia and laryngeal dysfunction are known to impact on health outcomes of patients with critical illness. The incidence in patients after heart and/or lung transplantation is unknown. This paper investigates the frequency, characteristics and risk factors for these complications following such transplantation. Read More

Swiss Med Wkly 2018 12 4;148:w14692. Epub 2019 Jan 4.

Division of Immunology and Allergy, Department of Medical Specialties, University Hospitals and Medical Faculty, Geneva, Switzerland / Jules Gonin Eye Hospital, Lausanne, Switzerland.

Aims: Vocal cord dysfunction (VCD) is characterised by paradoxical inspiratory laryngeal motion and is often misdiagnosed as asthma. Definitive diagnosis of VCD is difficult, because laryngoscopy is positive only during symptomatic episodes or upon provocation with exercise or inhaled irritants. The aims of the study were to better characterise the symptomatology of patients with VCD and to evaluate the potential usefulness of less-invasive diagnostic tools, namely provocation tests and spirometry. Read More

Transpl Int 2019 Jan 21. Epub 2019 Jan 21.

Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.

Vocal cord paralysis (VCP) may complicate thoracic surgery and is associated with increased morbidity and mortality. Among lung transplant (LTx) recipients, chronic pulmonary aspiration can contribute to chronic allograft dysfunction (CLAD). We herein assessed the unknown incidence and clinical impact of VCP in a large LTx cohort. Read More

J Voice 2019 Jan 16. Epub 2019 Jan 16.

Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin.

Objective: To investigate patient-level predictors of initiation of voice therapy for paradoxical vocal fold motion disorder (PVFM).

Study Design: Prospective outcomes database study.

Methods: Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database between March 2010 and November 2016 who were diagnosed with PVFM and recommended for voice therapy were eligible. Read More

Semin Respir Crit Care Med 2018 Dec 14;39(6):667-673. Epub 2019 Jan 14.

Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Excessive central airway collapse (ECAC) is characterized by excessive narrowing of the airway lumen during exhalation leading to dyspnea, cough, mucostasis, recurrent respiratory infections, and poor quality of life. Tracheobronchomalacia and excessive dynamic airway collapse are heterogeneous entities of ECAC and are characterized by a diverse nonspecific symptom profile. Although the pathophysiology of airway mechanics as well as morphology in both entities is different, current evidence so far shows no practical benefit in making such distinction since both have similar symptoms and the diagnostic and therapeutic work-ups are the same. Read More

J Pediatr Surg 2018 Oct 31. Epub 2018 Oct 31.

Division of Pediatric Surgery, Hiram C. Polk, Jr., M.D. Department of Surgery, University of Louisville, Louisville, KY.

Isolated tracheoesophageal fistula (TEF) is a rare condition with a previously reported high incidence of vocal cord paresis. A technique using recurrent laryngeal nerve monitoring is described as a strategy to potentially minimize the risk of vocal cord dysfunction in this patient population. Read More

Int J Pediatr Otorhinolaryngol 2019 Mar 2;118:68-72. Epub 2018 Dec 2.

Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, USA.

Introduction: Paradoxical vocal fold movement dysfunction (PVFMD) is a disorder in which the vocal folds involuntarily adduct during inspiration resulting in stridor, cough, dysphonia and dyspnea. Diagnosis of PVFMD is difficult given the episodic nature of the disorder and the often-normal laryngeal exam in between episodes. Moreover, additional sources of obstruction have been identified as sources of Periodic Occurrence of Laryngeal Obstruction (POLO). Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 27;117:179-181. Epub 2018 Nov 27.

Dr. Ersin Arslan Research and Training Hospital, Department of Medical Genetics, Gaziantep, Turkey.

Congenital bilateral laryngeal paralysis/immobilization is an uncommon condition and has been described as isolated or accompanying to some recognizable syndromes. Heterozygous mutations in the FOXP1 gene (605515) are related with intellectual disability and, language impairment with or without autistic features. Expressive language is more affected than receptive language and more than half of the patients experience oromotor dysfunction and/or feeding difficulties. Read More

J Peripher Nerv Syst 2019 Mar 16;24(1):145-149. Epub 2019 Jan 16.

Department of Neurology, National Neuroscience Institute, Singapore, Singapore.

We aimed to elucidate characteristics of beriberi neuropathy (BB) in a general hospital (GH) setting. Nerve conduction studies (NCS), cross-referenced with clinical records of patients admitted to a GH (May 2011-July 2017), were reviewed for diagnosis of BB. Thirteen patients (age range 23-64 years; five women) were diagnosed with BB. Read More

Gland Surg 2018 Oct;7(5):433-439

Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.

Background: Post-thyroidectomy dysphonia can result from recurrent laryngeal nerve (RLN) injury. Confirmation of postoperative recurrent nerve function has prompted many surgeons to advocate laryngoscopic examination. Indirect and flexible laryngoscopy permit visualization of vocal cord motion, but not all thyroid surgeons are skilled in these techniques. Read More

Paediatr Drugs 2019 Feb;21(1):25-31

Mother and Child Health, and Radiology Department, Cádiz University, Cadiz, Spain.

Background: Upper gastrointestinal endoscopies (UGEs) performed under ketamine sedation may increase the risk of respiratory adverse events (RAEs) due to pharyngeal stimulation. Topical lidocaine prevents general anesthesia-induced laryngospasm.

Objective: Our objective was to determine whether topical lidocaine may reduce the incidence of RAEs induced by pharyngeal stimulation in UGEs performed on children sedated with ketamine. Read More

World Neurosurg 2019 Feb 19;122:380-383. Epub 2018 Nov 19.

Department of Neurological Surgery, UCSF Medical Center, University of California, San Francisco, San Francisco, California, USA. Electronic address:

Background: Vocal cord dysfunction resulting from recurrent laryngeal nerve palsy (RLNP) is a known complication following anterior cervical discectomy and fusion. RLNP occurs typically secondary to neurapraxia caused by intraoperative compression or traction on the nerve and less commonly from direct nerve injury intraoperatively in the setting of anterior cervical spine surgery. Patients with RLNP typically present with hoarseness immediately after surgery owing to unilateral vocal cord paralysis. Read More

Eur Respir Rev 2018 Dec 21;27(150). Epub 2018 Nov 21.

NIHR Clinical Research Facility, Manchester University NHS Foundation Trust, Manchester, UK.

Ear, nose and throat (ENT) comorbidities are common in patients with asthma and are frequently associated with poorer asthma outcomes. All these comorbidities are "treatable traits" in asthma. Identification and management of these disorders may spare medication usage and contribute to improved asthma control and quality of life, and a decrease in exacerbation rates. Read More

Med J Aust 2018 Jul;209(2):S11-S17

Monash Lung and Sleep, Monash Hospital and University, Melbourne, VIC.

Asthma care has increasingly focused on personalised management for severe asthma, and recognition of the role and importance of comorbid conditions has increased. Severe asthma can be crippling; associated comorbid conditions often play a key role in the significant disease morbidity and frequently contribute to a severe and difficult-to-treat asthma phenotype. Comorbid conditions can be broadly grouped as being either airway-related or airway-unrelated. Read More

Indian Pediatr 2018 Oct;55(10):905-906

Division of Neonatology, Amrita Institute of Medical Sciences, Amrita University, Kochi, India. Correspondence to: Dr Sasidharan Ponthenkandath, Amrita Institute of Medical Sciences, Amrita University, Kochi, India.

Background: Intractable obstructive apneas requiring multiple intubations are rare in newborns.

Case Characteristics: We report a pair of twins born at 29 weeks gestation who had severe obstructive apneas due to Paradoxical Vocal Cord Motion (PVCM).

Outcome: The symptoms resolved promptly with ipratropium nebulization. Read More

Eur Arch Otorhinolaryngol 2018 Dec 22;275(12):3033-3037. Epub 2018 Oct 22.

Department of Otolaryngology, Selcuk University Medical School, Alaeddin Keykubad Campus, 42075 Yeni Istanbul caddesi, Konya, Turkey.

Purpose: To evaluate upper esophageal sphincter (UES) activity in patients with benign glottic lesions.

Methods: Twenty-three patients with benign vocal fold (VF) lesions scheduled for manometric evaluation were enrolled as the study group (SG); 20 healthy subjects without vocal pathology or dysphagia were included as the control group (CG). UES residual, basal, relaxation time and peak pharyngeal pressures were evaluated by manometry. Read More

Front Pediatr 2018 3;6:276. Epub 2018 Oct 3.

Paediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep and Long Term Ventilation Unit, Department of Paediatrics, Paediatric Hospital "Bambino Gesù" Research Institute, Rome, Italy.

Childhood asthma remains a multifactorial disease with heterogeneous clinical phenotype and complex genetic inheritance. The primary aim of asthma management is to achieve control of symptoms, in order to reduce the risk of future exacerbations and progressive loss of lung function, which results especially challenging in patients with difficult asthma. When asthma does not respond to maintenance treatment, firstly, the correct diagnosis needs to be confirmed and other diagnosis, such as cystic fibrosis, primary ciliary dyskinesia, immunodeficiency conditions or airway and vascular malformations need to be excluded. Read More

Surgery 2019 Jan 14;165(1):242-249. Epub 2018 Oct 14.

Department of Surgery, Duke University Medical Center, Durham, NC.

Background: Multi-institutional data describing remedial parathyroidectomy compared with index parathyroidectomy are scarce.

Methods: Using data in the Collaborative Endocrine Surgery Quality Improvement Program (2014-2017), baseline characteristics and outcomes of patients undergoing remedial parathyroidectomy versus index parathyroidectomy were examined using bivariate and multivariate methods. Rates of hypercalcemia and hypocalcemia at ≥ 180 days were assessed. Read More

Ann Otol Rhinol Laryngol 2018 Dec 8;127(12):962-968. Epub 2018 Oct 8.

1 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

Objectives:: Cell therapies using mesenchymal stromal cells (MSCs) have been proposed as a promising new tool for the treatment of vocal fold scarring. However, the mechanisms by which MSCs promote healing as well as their duration of survival within the host vocal fold have yet to be defined. The aim of this work was to assess the persistence of embedded MSCs within a tissue-engineered vocal fold mucosal replacement in a rabbit model of vocal fold injury. Read More

J Pediatr Surg 2018 Sep 9. Epub 2018 Sep 9.

Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, ON, Canada. Electronic address:

Background: The purpose of this study was to determine risk factors and long-term outcomes in patients with esophageal atresia +/-tracheoesophageal fistula (EA/TEF) with vocal cord dysfunction (VCD) owing to recurrent laryngeal nerve (RLN) injury.

Method: A retrospective chart review was performed for EA/TEF patients repaired at our institution from 1999 to 2014 (REB #1000032265).

Results: Of 197 patients, 22 (11. Read More

Respirology 2019 Jan 19;24(1):37-47. Epub 2018 Sep 19.

Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.

Background And Objective: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whether treatable traits could be identified using registry data and whether particular treatable traits were associated with future exacerbation risk.

Methods: The Australasian Severe Asthma Web-Based Database (SAWD) enrolled 434 participants with severe asthma and a comparison group of 102 participants with non-severe asthma. Read More

Pediatr Qual Saf 2018 May-Jun;3(3):e080. Epub 2018 May 18.

Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah.

Introduction: Feeding difficulties and malnutrition are important challenges when caring for newborns with critical congenital heart disease (CCHD) without clear available guidelines for providers. This study describes the utilization of a feeding protocol with the focus on standardization, feeding modality, and total parenteral nutrition (TPN) utilization postoperatively.

Methods: Patients included neonates with CCHD undergoing complex biventricular repair using cardiopulmonary bypass. Read More

Ann Otol Rhinol Laryngol 2018 Nov 6;127(11):754-762. Epub 2018 Sep 6.

5 Department of Communication Sciences and Disorders, University of Delaware, Newark, Deleware, USA.

Objectives: (1) Identify laryngeal patterns axiomatic to exercise-induced laryngeal obstruction (EILO) and (2) investigate the role of autonomic function in EILO.

Methods: Twenty-seven athletic adolescents (13 EILO, 14 control) underwent laryngoscopy at rest and exercise. Glottal configurations, supraglottic dynamics, systolic blood pressure responses, and heart rate recovery were compared between conditions and groups. Read More

BMJ Case Rep 2018 Aug 29;2018. Epub 2018 Aug 29.

Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan.

The practice of complementary and non-formulary medicine has gained tremendous popularity due to their claimed beneficial effects in cardiac, respiratory and chronic diseases, as also other disorders. The most threatening aspect related to these practices pertains to the non-disclosure of its use by patients at the time of their preoperative assessment in elective or emergency setting. We report a case of profound, long-lasting unexplained hypotension during and after anaesthesia in a patient presented for emergency vocal cord surgery (cordectomy). Read More

Respir Med Case Rep 2018 3;25:104-108. Epub 2018 Aug 3.

Division of Pulmonary, Allergy, and Critical Care Medicine; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: Vocal cord dysfunction (VCD) is defined as inappropriate movement of the vocal cords resulting in functional airway obstruction and symptoms including cough, wheezing, and dyspnea. VCD is often misdiagnosed with asthma but can also co-exist with asthma. The association of VCD with other serious pulmonary conditions has not been described to date. Read More

Clin J Sport Med 2018 Aug 8. Epub 2018 Aug 8.

Department of Otolaryngology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.

Objective: Vocal cord dysfunction (VCD) is characterized by paradoxical vocal fold movement (PVFM) during inspiration. The aim of this study was to determine whether ultrasound could accurately differentiate between normal and PVFM during respirations in a resting state.

Design: Prospective, single-subject design. Read More

Laryngoscope Investig Otolaryngol 2018 Jun 14;3(3):249-252. Epub 2018 May 14.

Department of Head and Neck Surgery Tata Memorial Hospital Mumbai India.

Objective: Total thyroidectomy with or without central compartment dissection is the treatment of choice for thyroid carcinoma. Extensive dissection along the recurrent laryngeal nerve (RLN) can lead to vocal cord fixity and hoarseness even without nerve sacrifice. Recovery rates after surgery for thyroid cancers have not been well documented. Read More

J Neurosurg 2018 Jul 1:1-5. Epub 2018 Jul 1.

4Anesthesiology, Pharmacology and Therapeutics at the University of British Columbia, Vancouver, British Columbia, Canada.

Inducible laryngeal obstruction has been described under at least 40 different monikers, including vocal cord dysfunction, paroxysmal vocal fold motion, and irritable larynx. The etiology of this condition is believed to be laryngeal hyperactivity in response to psychological issues or acid reflux. Most patients are treated with some combination of proton pump inhibitors, speech therapy, and psychotherapy. Read More

Respir Physiol Neurobiol 2019 01 30;259:16-25. Epub 2018 Jun 30.

PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Brazil. Electronic address:

Aim: To assess thoracoabdominal asynchrony (TAA) and the presence of paradoxical motion in middle stage amyotrophic lateral sclerosis (ALS) and its relationships with chest wall tidal volume (V), breathing pattern and cough peak flow (CPF).

Methods: Phase angle (θ) between upper (RCp) and lower ribcage (RCa) and abdomen (AB), as well as percentage of inspiratory time for the lower ribcage (IP) and abdomen (IP) moving in opposite directions were quantified using optoelectronic plethysmography in 12 ALS patients during quiet breathing and coughing. Paradoxical motion of the compartments was based on threshold values of θ and IP, obtained in twelve age and sex matched healthy persons. Read More

Semin Pediatr Neurol 2018 07 4;26:10-14. Epub 2017 Apr 4.

Division of Paediatric Neurology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.

This report describes the first case of a child with genetically confirmed Brown-Vialetto-van Laere syndrome in sub-Saharan Africa. This is an extremely rare clinical condition that presents with an auditory neuropathy, bulbar palsy, stridor, muscle weakness, and respiratory compromise that manifests with diaphragmatic and vocal cord paralysis. It is an autosomal recessive condition for which the genetic mutation has only recently been linked to a riboflavin transporter deficiency. Read More

Genes (Basel) 2018 Jun 25;9(7). Epub 2018 Jun 25.

Department of Otolaryngology-Head & Neck Surgery, National Defense Medical College, Saitama 3598513, Japan.

Recurrent laryngeal nerve (RLN) injury has considerable clinical implications, including voice and swallowing dysfunction, which may considerably impair the patient’s quality of life. Recovery of vocal fold movement is an essential novel treatment option for RLN injury. The potential of gene therapy for addressing this issue is highly promising. Read More

Ear Nose Throat J 2018 Apr-May;97(4-5):128-136

Department of Internal Medicine, American University of Beirut Medical Center, Lebanon.

The objective of the study was to analyze the frequency and severity of vocal tract symptoms in patients on statins. A total of 73 patients were enrolled in this study, 44 patients who were taking statins and 29 controls not taking statins. The severity and frequency of vocal tract discomfort was assessed using the Vocal Tract Discomfort scale. Read More

Acta Myol 2017 Sep 1;36(3):125-134. Epub 2017 Sep 1.

Department of Neurosurgery, Ulm University, Ulm, Germany.

Introduction: Myotonia permanens due to Nav1.4-G1306E is a rare sodium channelopathy with potentially life-threatening respiratory complications. Our goal was to study phenotypic variability throughout life. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Mar;32(6):412-419

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing.

Objectives: To analyze the clinical characteristics of paroxysmal laryngospasm in adult.

Methods: A retrospective analysis was performed on 149 patients with paroxysmal laryngospasm in adult. All patients underwent the strobolaryngoscopy, completed the reflux symptom index (RSI) or the reflux finding score (RFS). Read More

J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):2087-2095. Epub 2018 May 3.

Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.

Background: Chronic refractory cough (CRC), a phenotype of cough hypersensitivity syndrome (CHS), is a disabling problem. Laryngeal dysfunction may be important in CRC and CHS because laryngeal symptoms are common; however, the role of laryngeal dysfunction in CHS has not been systematically examined.

Objective: To determine the nature of laryngeal dysfunction in patients with CRC and compare with the related laryngeal conditions of vocal cord dysfunction (VCD) and muscle tension dysphonia (MTD). Read More

Pediatr Rev 2018 May;39(5):261

Penn State Milton S. Hershey Medical Center, Hershey, PA.

Auris Nasus Larynx 2018 Dec 20;45(6):1214-1220. Epub 2018 Apr 20.

Department of Otorhinolaryngology - Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan; Department of Biology and Function in Head and Neck, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Objective: The Hyodo scoring system during the endoscopic procedure has been proposed as a new tool for evaluating oral intake feasibility. However, the effectiveness of the information obtained from this procedure in predicting aspiration is not fully elucidated. The aim of this study was to assess the significance of clinical factors, including Hyodo scores, for predicting the risk of aspiration. Read More

J Pediatr Health Care 2019 Jan 13;33(1):5-13. Epub 2018 Apr 13.

Vocal cord dysfunction is an obstruction of the upper airway, primarily on inspiration, due to the paradoxical adduction of the vocal cords. Vocal cord dysfunction continues to be underdiagnosed as its own entity. The lack of diagnosis can be attributed to the overlap of symptoms between asthma and exercise-induced bronchospasm. Read More

Clin Case Rep 2018 04 4;6(4):735-740. Epub 2018 Mar 4.

Department of Otorhinolaryngology Mayo Clinic 200 First St. SW Rochester Minnesota 55905.

Laryngoscopy is the gold standard to diagnose exercise-induced laryngeal obstruction, though inspiratory flow-volume loop may provide a clue. We combined tidal flow-volume loop analysis laryngoscopy during exercise and found that cigar-shaped - flattened - inspiratory loops are associated with obstruction. Pursed-lip breathing slows inhalation thereby reducing vocal fold adduction. Read More

Immunol Allergy Clin North Am 2018 05 23;38(2):303-315. Epub 2018 Feb 23.

Erika Westhoff Performance, Pleasanton, CA, USA.

Exercise-induced laryngeal obstruction causes severe shortness of breath during exercise. Episodes are associated with severe distress. These patients and those with inducible laryngeal obstruction triggered by other factors have been noted to demonstrate mental health disorders, personality features that may be associated with symptoms, and dysfunctional stress responses. Read More