Abstract
Post-extubation stridor frequently causes weaning failure in mechanically ventilated patients. The most common causes of post-extubation stridor are vocal cord edema and paralysis. Paradoxical vocal fold motion (PVFM) is a laryngeal disorder characterized by inappropriate adduction of the vocal cords during inspiration, expiration, or both. Clinically, this disorder is often misdiagnosed as an asthma attack but rarely is it associated with postextubation stridor. A 62-year-old man with vocal cord paralysis and acute respiratory failure developed post-extubation stridor and was identified as having PVFM. We present the typical findings on bronchoscopy. The characteristic patterns of spirometry, including notching and a flattened or truncated flow-volume loop, are also described.
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