What is Paradoxical Vocal Fold Movement (PVFM)?

---

The best way to explain paradoxical vocal fold movement is to begin with normal vocal fold movement. Basically, the vocal folds move in two major directions. When we take a breath, they OPEN and let air in. When we talk, they CLOSE so that they can vibrate together.

PVFM is a functional disorder where the vocal cords are normal in appearance, and they do move. However, the disorder occurs when they move in the wrong direction. If the vocal cords move together when you try to take a breath, this will narrow the top of the windpipe. High pitched, noisy breathing can happen then and patients will feel like they are having some trouble getting air in. Though the proper name for this is stridor, some people use the term “wheezing” to describe this noisy breathing.

Patients with PVFM are best treated by a team of clinicians. Many studies show that PVFM can be related to PTSD, and patients report worse symptoms when they are stressed. Mental health evaluation and treatment is usually helpful for this. Speech therapy to work on breathing techniques like Buteyko breathing can also be helpful. In rare cases, the Laryngologist may need to give botox into the vocal muscles to weaken them so that they will be less likely to move in the wrong direction.