O'Connell Ferster AP, et al. - Herein, the clinical course, approach to treatment and outcomes for infants with paradoxical vocal fold motion (PVFM) were evaluated by the experts. Data demonstrated that in the infant population, PVFM could be challenging to diagnose. With the reflux treatment, PVFM resolved uneventfully. Nonetheless, whether reflux treatment was important or if PVFM would resolve spontaneously, remained unknown. Because of the rarity of the infantile PVFM, formal evaluation and monitoring by a pediatric otolaryngologist became mandatory.

Methods

• Authors conducted a retrospective review in a tertiary academic medical center.
• They identified and included patients less than 2 years of age diagnosed with PVFM.
• For patients less than 2 years old with PVFM, the history, physical exam findings, and clinical course of treatment were reviewed.
• This was followed by a compilation of the findings including those on flexible fiberoptic laryngoscopy (FFL) and subjective assessment by parents and clinicians for the review.

Results

• During this study, 7 infants were diagnosed with PVFM.
• It was determined that all the subjects were full term at birth, and 7 months was the average age at diagnosis.
• Initially, all the patients were presented with inspiratory stridor, and 2 patients had stertor.
• A history of reactive airway disease was seen in 2 of 7 patients and 1 with laryngomalacia.
• Data demonstrated a history of reflux in 5 cases.
• Herein, 2 of 7 patients were found to have weight percentiles at diagnosis lower than the 25th percentile, whereas the remaining were between 37th and 75th percentiles.
• Stridor was revealed in all patients on initial voice evaluation, along with the finding of PVFM on FFL.
• An anti-reflux medication was started for all the patients.
• Following treatment, 5.9 months was discovered to be the average time for the resolution of PVFM.