Highlights & Basics
- Paradoxical vocal fold motion (intermittent laryngeal obstruction) (PVFM/ILO) is a breathing disorder that is frequently mistaken for asthma.
- Accurate diagnosis is made by a multidisciplinary team, which can include a speech language pathologist, a primary care physician, an asthma/allergy specialist, a pulmonologist, a psychologist, a psychiatrist, a sports medicine specialist, an athletic trainer, and a gastroenterologist.
- Diagnosis is established through the case history, continuous laryngeal visualization during exercise, and pulmonary function studies.
- Behavioral therapy by a speech language pathologist is the standard treatment.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Normal larynx: normal color of vocal folds and surrounding structures, smooth vocal fold edges
Irritable larynx: bilateral erythema of the arytenoid complex bilaterally with tissue changes suggestive of early granuloma
Laryngopharyngeal reflux: bilateral edema and erythema of the vocal folds with epithelial layer thickness, interarytenoid thickness
Reproduction of breathing attack: adduction of arytenoid complex during inhalation
Abduction breathing exercise: abduction of the arytenoid complex bilaterally with nasal inhalation
Citations
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Clemm HH, Olin JT, McIntosh C, et al. Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC Consensus on 'acute respiratory illness in the athlete'. Br J Sports Med. 2022 Jun;56(11):622-9.[Abstract][Full Text]
Leong P, Vertigan AE, Hew M, et al. Diagnosis of vocal cord dysfunction/inducible laryngeal obstruction: an international delphi consensus study. J Allergy Clin Immunol. 2023 Oct;152(4):899-906.[Abstract][Full Text]
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