Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.
Heart Lung Circ. 2011 Sep;20(9):602-4. doi: 10.1016/j.hlc.2011.02.007. Epub 2011 Apr 1.
Paradoxical vocal cord movement (PVCM) is a laryngeal disorder characterised by paradoxical adduction of the vocal cords during inspiration, expiration, or both. In severe cases patients can present with acute respiratory failure requiring intubation and mechanical ventilation. Paradoxical vocal cord movement can be due to different conditions including central nervous system injury, conversion disorders, psychological stress, inhaled irritants, and true laryngeal dystonias. Paradoxical vocal cord movement has also been described in association with cardiac surgery. Most cases of mild PVCM are successfully treated with a combination of speech therapy, patient education, and psychotherapy. In severe cases, patients might require tracheostomy. We report a case of a 65 year-old man who developed severe PVCM post coronary artery bypass surgery requiring tracheostomy for six months. He was successfully treated with bronchoscopic injection of Botulinum toxin type A into his vocal cords. He was decannulated one week after the injection, and was doing well at six weeks follow up.
矛盾性喉运动（PVCM）是一种喉部疾病，其特征是声带在吸气、呼气或两者同时出现反常内收。在严重的情况下，患者可能会出现急性呼吸衰竭，需要插管和机械通气。PVCM 可由多种情况引起，包括中枢神经系统损伤、转换障碍、心理压力、吸入性刺激物和真性喉肌张力障碍。PVCM 也与心脏手术有关。大多数轻度 PVCM 病例通过联合言语治疗、患者教育和心理治疗即可成功治疗。在严重的情况下，患者可能需要气管切开术。我们报告了一例 65 岁男性患者，在冠状动脉旁路手术后出现严重的 PVCM，需要进行气管切开术 6 个月。他成功地接受了经支气管镜将肉毒毒素 A 注射到声带的治疗。注射后一周他就可以拔管，并且在 6 周的随访中恢复良好。
