Medical Comorbidities for Paradoxical Vocal Fold Motion (Vocal Cord Dysfunction) in the Military Population
Accepted 27 March 2009. published online 05 November 2009. Corrected Proof
Summary
Objectives/Hypotheses
This study aimed to describe the demographic characteristics of patients diagnosed with paradoxical vocal fold motion (PVFM) at Walter Reed Army Medical Center (WRAMC), and to document common medical comorbidities. The military population was expected to differ from the general population because of a presumed association between high physical demands and PVFM.
Study Design
Retrospective chart review of active-duty (AD) military personnel compared with a natural control group of non-AD patients.
Methods
Reports of asthma, allergy, gastroesophageal reflux disease (GERD), and postnasal drip (consequent to chronic sinusitis) were recorded for patients referred to the Speech Pathology Clinic at WRAMC with a diagnosis of PVFM from 1996 to 2001.
Results
The cohort consisted of 265 patients, 127 of whom were on AD status. The AD group was significantly younger and represented a narrower age range (17–53 years) than the non-AD patients (8–80 years), and had a more balanced sex ratio (1.2:1 vs 2.9:1). Eighty percent of all patients had at least one of the medical comorbidities surveyed, and 51% had two or more factors. GERD and allergies were reported most commonly by both groups; only asthma occurred significantly more in non-AD than AD patients.
Conclusions
PVFM referrals of AD personnel of the US military are characterized by younger patients and a smaller female:male ratio as compared with non-AD patients. Based on the preponderance of men in the military, the number of females in the AD group remained disproportionately large. Multiple medical comorbidities were commonly documented by both groups; the only significant difference was a greater prevalence of asthma in the non-AD group. These data reinforce the need for appropriate differential diagnosis in all patients.
∗Department of Surgery, Army Audiology and Speech Center, Walter Reed Army Medical Center, Washington, District of Columbia
†Department of Medicine, Pulmonary & Critical Care Service, Walter Reed Army Medical Center, Washington, District of Columbia
‡Department of Surgery, Otolaryngology Head and Neck Service, Walter Reed Army Medical Center, Washington, District of Columbia
Address correspondence and reprint requests to Nancy Pearl Solomon, 6900 Georgia Avenue NW, Washington, DC 20307.
Disclaimer: The views expressed are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the US Government. No author has a known conflict of interest with any aspect of the work represented here. These data were presented at the 3rd National Conference on Vocal Cord Dysfunction/Paradoxical Vocal Function Motion, Denver, CO, in July 2007.
ABSTRACT