Vertigan Anne E, Gibson Peter G, Theodoros Deborah G, Winkworth Alison L
Speech Pathology Department, John Hunter Hospital, Newcastle, Australia.
Curr Opin Allergy Clin Immunol. 2007 Feb;7(1):37-42. doi: 10.1097/ACI.0b013e328012c587.
Chronic cough and paradoxical vocal fold movement (PVFM) are perplexing conditions. This paper reviews the recent literature in relation to the nature of PVFM and chronic cough and the management of symptoms associated with these disorders.
There are similarities in the voice and upper airway symptoms in chronic cough and PVFM. Clinically significant voice symptoms are present in approximately 40% of individuals with chronic cough and PVFM and are similar to those occurring in voice disorders such as muscle tension dysphonia. Chronic cough can be associated with PVFM in a large proportion of cases. Extrathoracic airway hyperresponsiveness is a common underlying mechanism in PVFM and chronic cough. Speech pathology intervention can be effective in controlling symptoms in chronic cough, which suggests that the anatomic diagnostic protocol could be expanded to incorporate this intervention. Chronic cough that fails to respond to medical management should be conceptualized as either due to PVFM or idiopathic. PVFM and chronic cough are not necessarily the result of underlying psychopathology.
Chronic cough and PVFM manifest in a range of clinically significant voice and upper airway symptoms. The anatomic diagnostic protocol used in the management of chronic cough could be expanded to include PVFM as a potential cause of cough, and speech pathology intervention as treatment for chronic cough.
慢性咳嗽和矛盾性声带运动障碍（PVFM）是令人困惑的病症。本文回顾了近期有关PVFM的本质、慢性咳嗽以及与这些疾病相关症状管理的文献。
慢性咳嗽和PVFM在嗓音及上气道症状方面存在相似之处。在约40%的慢性咳嗽和PVFM患者中存在具有临床意义的嗓音症状，且与诸如肌肉紧张性发声障碍等嗓音疾病中出现的症状相似。在很大一部分病例中，慢性咳嗽可能与PVFM相关。胸外气道高反应性是PVFM和慢性咳嗽常见的潜在机制。言语病理学干预对于控制慢性咳嗽症状可能有效，这表明解剖学诊断方案可扩大至纳入这种干预措施。对药物治疗无反应的慢性咳嗽应被视为要么是由PVFM引起，要么是特发性的。PVFM和慢性咳嗽不一定是潜在精神病理学的结果。
慢性咳嗽和PVFM表现为一系列具有临床意义的嗓音和上气道症状。用于慢性咳嗽管理的解剖学诊断方案可扩大至将PVFM作为咳嗽的潜在病因纳入，并将言语病理学干预作为慢性咳嗽的治疗方法。
