Three cases of paradoxical vocal cord adduction followed up over a 10-year period.

Paradoxical vocal cord adduction (PVCA) is a rare disorder that may present with symptoms similar to asthma. Incorrect diagnosis may result in patients being unwittingly treated with prolonged high doses of antiasthma medication. PVCA probably forms part of a spectrum of uncommon and complex breathing disorders related to laryngeal dysfunction. Herein, we describe three cases of PVCA that illustrate the spectrum of clinical and physiologic presentation and the long-term natural history over a 10-year follow-up period. We conclude that PVCA, contrary to previous reports, is not always a benign condition; it may feature marked hypoxemia, fail to respond to previously advocated therapeutic strategies, and can persist on a long-term basis.