Respiratory retraining therapy in long-term treatment of paradoxical vocal fold dysfunction

Folia Phoniatr Logop. 2011;63(3):134-41. doi: 10.1159/000316405. Epub 2010 Oct 8.


Objectives: Paradoxical vocal fold dysfunction (PVFD) is a disorder in the larynx featuring involuntary adduction of the vocal folds during the inspiratory phase of breathing. The symptoms include acute episodes of dyspnea and bouts of coughing. To date, there is no universally acknowledged treatment for PVFD, though respiratory retraining therapy is the treatment of choice.

Aims: The purpose of this work was to evaluate the results of long-term respiratory retraining therapy in cases of PVFD.

Patients and methods: We treated 20 patients with PVFD for 2 years: 10 subjects were submitted to a cycle of respiratory retraining therapy every 12 months (receiving a total of 3 cycles) while 10 were given a cycle every 3 months (for a total of 9 cycles) no matter what their clinical conditions were.

Results: The results show that long-term respiratory retraining is particularly efficacious if the cycles of treatment are repeated, no matter what clinical conditions are present. In fact, when only one cycle of retraining treatment is given a year, there is initial improvement followed by progressive worsening.

Conclusions: Long-term respiratory rehabilitation is effective, especially if the treatment is given at least once every 3 months.

MeSH terms

  • Adult
  • Anti-Anxiety Agents / therapeutic use
  • Benzodiazepines / therapeutic use
  • Breathing Exercises*
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Dyspnea / etiology
  • Female
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / diagnosis
  • Humans
  • Inhalation
  • Laryngeal Diseases / complications
  • Laryngeal Diseases / diagnosis
  • Laryngeal Diseases / drug therapy
  • Laryngeal Diseases / rehabilitation
  • Laryngeal Diseases / therapy*
  • Laryngeal Muscles / physiopathology*
  • Laryngoscopy
  • Male
  • Middle Aged
  • Muscle Hypertonia / diagnosis
  • Muscle Hypertonia / drug therapy
  • Muscle Hypertonia / rehabilitation
  • Muscle Hypertonia / therapy
  • Recurrence
  • Relaxation Therapy*
  • Treatment Outcome
  • Vocal Cords / physiopathology*


  • Anti-Anxiety Agents
  • Benzodiazepines