The incidence and prevalence of paradoxical vocal fold motion (intermittent laryngeal obstruction) (PVFM/ILO) have not been well established in the general population. A 2.8% prevalence of PVFM/ILO has been found in those referred for evaluation of dyspnea.[19]Kenn K, Willer G, Bizer C, et al. Prevalence of vocal cord dysfunction in patients with dyspnea: first prospective clinical study. Am J Respir Crit Care Med. 1997;155:A965. In large literature reviews, of those reporting paradoxical vocal cord movement dysfunction, 70% to 74% were adult and 26% children, the age range was infancy to 82 years.[20]Morris MJ, Allan PF, Perkins PJ. Vocal cord dysfunction: etiologies and treatment. Clin Pulm Med. 2006;13:73-86.[21]Brugman S. The many faces of vocal cord dysfunction: what 36 years of literature tells us. Am J Respir Crit Care Med. 2003;167:A588. Several studies describe the incidence of PVFM/ILO in subpopulations. Studies have reported prevalence rates of exercise-induced ILO in the adolescent population ranging from 5% to 8%, and as high as 35% among athletes.[22]Johansson H, Norlander K, Berglund L, et al. Prevalence of exercise-induced bronchoconstriction and exercise-induced laryngeal obstruction in a general adolescent population. Thorax. 2015 Jan;70(1):57-63.
https://thorax.bmj.com/content/70/1/57.long
http://www.ncbi.nlm.nih.gov/pubmed/25380758?tool=bestpractice.com
[23]Ersson K, Mallmin E, Malinovschi A, et al. Prevalence of exercise-induced bronchoconstriction and laryngeal obstruction in adolescent athletes. Pediatr Pulmonol. 2020 Dec;55(12):3509-16.
https://onlinelibrary.wiley.com/doi/10.1002/ppul.25104
http://www.ncbi.nlm.nih.gov/pubmed/33002318?tool=bestpractice.com
[24]Nielsen EW, Hull JH, Backer V. High prevalence of exercise-induced laryngeal obstruction in athletes. Med Sci Sports Exerc. 2013 Nov;45(11):2030-5.
https://journals.lww.com/acsm-msse/fulltext/2013/11000/high_prevalence_of_exercise_induced_laryngeal.2.aspx
http://www.ncbi.nlm.nih.gov/pubmed/23657163?tool=bestpractice.com
PVFM/ILO-positive findings have been reported in up to 15% of active military-duty adults with exercise-induced asthma symptoms and 5.1% of elite athletes.[25]Morris MJ, Deal LE, Bean DR, et al. Vocal cord dysfunction in patients with exertional dyspnea. Chest. 1999;116:1676-82.
http://journal.publications.chestnet.org/article.aspx?articleid=1078336
http://www.ncbi.nlm.nih.gov/pubmed/10593794?tool=bestpractice.com
[26]Campisi ES, Schneiderman JE, Owen B, et al. Exercise-induced laryngeal obstruction: Quality initiative to improve assessment and management. Int J Pediatr Otorhinolaryngol. 2019 Dec;127:109677.
https://www.doi.org/10.1016/j.ijporl.2019.109677
http://www.ncbi.nlm.nih.gov/pubmed/31526937?tool=bestpractice.com
The condition has been documented to coexist with asthma in up to 50% of cases and with breathing difficulty in 10% of cases.[27]Newman KB, Dubester SN. Vocal cord dysfunction: masquerader of asthma. Semin Respir Crit Care Med. 1994;15:161.[28]Gavin LA, Wamboldt M, Brugman S, et al. Psychological and family characteristics of adolescents with vocal cord dysfunction. J Asthma. 1998;35:409-417.
http://www.ncbi.nlm.nih.gov/pubmed/9734348?tool=bestpractice.com
[29]Dunn NM, Katial RK, Hoyte FCL. Vocal cord dysfunction: a review. Asthma Res Pract. 2015;1:9.
https://asthmarp.biomedcentral.com/articles/10.1186/s40733-015-0009-z
http://www.ncbi.nlm.nih.gov/pubmed/27965763?tool=bestpractice.com
[30]Low K, Lau KK, Holmes P, et al. Abnormal vocal cord function in difficult-to-treat asthma. Am J Respir Crit Care Med. 2011 Jul 1;184(1):50-6.
https://www.atsjournals.org/doi/10.1164/rccm.201010-1604OC
http://www.ncbi.nlm.nih.gov/pubmed/21471099?tool=bestpractice.com
In general, there is a higher female preponderance, with reviews suggesting a female-to-male ratio ranging from 2:1 to 3:1.[19]Kenn K, Willer G, Bizer C, et al. Prevalence of vocal cord dysfunction in patients with dyspnea: first prospective clinical study. Am J Respir Crit Care Med. 1997;155:A965.[20]Morris MJ, Allan PF, Perkins PJ. Vocal cord dysfunction: etiologies and treatment. Clin Pulm Med. 2006;13:73-86.[21]Brugman S. The many faces of vocal cord dysfunction: what 36 years of literature tells us. Am J Respir Crit Care Med. 2003;167:A588.[27]Newman KB, Dubester SN. Vocal cord dysfunction: masquerader of asthma. Semin Respir Crit Care Med. 1994;15:161.[31]Hicks M, Brugman SM, Katial R. Vocal cord dysfunction/paradoxical vocal fold motion. Prim Care. 2008;35:81-103.
http://www.ncbi.nlm.nih.gov/pubmed/18206719?tool=bestpractice.com
[32]Kenn K. Vocal cord dysfunction: what do we really know? A review [in German]. Pneumologie. 2007;61:431-439.
http://www.ncbi.nlm.nih.gov/pubmed/17447211?tool=bestpractice.com
[33]Parker JM, Guerrero ML. Airway function in women: bronchial hyperresponsiveness, cough, and vocal cord dysfunction. Clin Chest Med. 2004;25:321-330.
http://www.ncbi.nlm.nih.gov/pubmed/15099892?tool=bestpractice.com
[34]Fujiki RB, Olson-Greb B, Thibeault SL. Clinical profiles of children and adolescents with induced laryngeal obstruction (ILO) and exercise induced laryngeal obstruction (EILO). Ann Otol Rhinol Laryngol. 2024 Feb;133(2):136-44.
http://www.ncbi.nlm.nih.gov/pubmed/37534611?tool=bestpractice.com