Department of Surgery, University of Wisconsin, Madison, United States.
Department of Psychiatry, Child and Adolescent Division, University of Utah School of Medicine, United States.
Int J Pediatr Otorhinolaryngol. 2022 Jul;158:111182. doi: 10.1016/j.ijporl.2022.111182. Epub 2022 May 14.
Paradoxical Vocal Fold Movement (PVFM) may cause airway restriction and resulting dyspnea in the pediatric population. Therapy with a speech-language pathologist (SLP) is the primary treatment for children and adolescents diagnosed with Paradoxical Vocal Fold Movement (PVFM). This study examined treatment duration and factors predicting number of therapy sessions required.
Data were drawn from the University of Wisconsin-Madison Voice and Swallow Clinics Outcome Database. One hundred and twelve children and adolescents were included in this study. Participants were diagnosed with PVFM, followed for therapy with a SLP, and were subsequently discharged from therapy with successful outcomes. Extracted data included number of therapy sessions, PVFM symptoms, patient demographics, medical history, and comorbid diagnoses. Regression was used to determine factors predicting therapy duration.
Patients completed an average of 3.4 therapy sessions before discharge. Comorbid behavioral health diagnosis (β = 1.96, t = 3.83, p < .01) and a history of upper airway surgeries (β = 1.26, t = 2.615, p = .01) were significant predictors of the number of therapy sessions required before discharge; both factors significantly increased therapy duration. Age, symptom trigger-type, reflux symptoms, and dysphonia did not predict therapy duration. Overall, our regression model accounted for 42% of the variance in number of sessions required (r = 0.42).
On average, 3.4 sessions of therapy with an SLP resolved PVFM symptoms. Children with a behavioral health diagnosis required an average of 5.45 sessions and those with a history of upper airway surgery an average of 4.3 sessions. Future work should examine the relationship between behavioral health care and PVFM treatment, as well as how PVFM treatment efficiency can be maximized.
反常声门运动（PVFM）可导致小儿气道受限和呼吸困难。言语语言病理学家（SLP）的治疗是诊断为反常声门运动（PVFM）的儿童和青少年的主要治疗方法。本研究检查了治疗持续时间和预测所需治疗次数的因素。
数据来自威斯康星大学麦迪逊分校语音和吞咽诊所结果数据库。本研究纳入了 112 名儿童和青少年。这些参与者被诊断为 PVFM，接受 SLP 治疗，随后成功完成治疗并出院。提取的数据包括治疗次数、PVFM 症状、患者人口统计学、病史和合并诊断。回归用于确定预测治疗持续时间的因素。
患者平均完成 3.4 次治疗后出院。合并行为健康诊断（β=1.96，t=3.83，p<0.01）和上呼吸道手术史（β=1.26，t=2.615，p=0.01）是预测出院前所需治疗次数的显著预测因素；这两个因素都显著增加了治疗持续时间。年龄、症状触发类型、反流症状和发音障碍均不能预测治疗持续时间。总的来说，我们的回归模型解释了所需治疗次数方差的 42%（r=0.42）。
平均而言，接受 SLP 治疗 3.4 次即可解决 PVFM 症状。有行为健康诊断的儿童需要平均 5.45 次治疗，有上呼吸道手术史的儿童需要平均 4.3 次治疗。未来的研究应检查行为保健与 PVFM 治疗之间的关系，以及如何最大限度地提高 PVFM 治疗效率。
