{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:00:22Z","timestamp":1777561222915,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Paradoxical vocal fold motion disorder (PVFMD) is a condition involving the inappropriate narrowing of the larynx with symptoms of laryngeal tightness and dyspnea. A 23-year-old woman was diagnosed with PVFMD by imaging, revealing dynamically constricted, supraglottic tissue, an abnormal adduction of the vocal cords with a characteristic \u201cposterior chink\u201d observed. After diagnosis, laryngeal control retraining protocols and biofeedback therapy were initiated. To treat persistent symptoms, interventions such as vocal fold botulinum toxin (BoNT) injections were performed with slight improvements. Ultimately, psychiatry performed 10 repetitive transcranial magnetic stimulations (rTMS) with a right\u2010sided, low\u2010frequency approach to treat the patient\u2019s underlying major depressive disorder and comorbid anxious distress. Afterward, the patient\u2019s symptoms were successfully reduced with an improvement in Dyspnea Severity Index. Although most patients with PVFMD were relieved with laryngeal control therapy, some are refractory and lack the literature on the best treatment. In this case, we followed the multidisciplinary approach and individualized our novel therapeutic strategies including especially rTMS, which successfully reduced symptoms. This is the first reported case of refractory PVFMD to be treated with novel interventions, and rTMS might play a role in PVFMD mitigation.<\/jats:p>","DOI":"10.1177\/01455613221129443","type":"journal-article","created":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T08:23:13Z","timestamp":1664612593000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Repetitive Transcranial Magnetic Stimulation, a Novel Therapeutic Strategy for Refractory Paradoxical Vocal Fold Motion Disorder"],"prefix":"10.1177","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2623-0317","authenticated-orcid":false,"given":"Tien-Ru","family":"Huang","sequence":"first","affiliation":[{"name":"National Defense Medical Center"},{"name":"Tri-Service General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ta-Chuan","family":"Yeh","sequence":"additional","affiliation":[{"name":"National Defense Medical Center"},{"name":"Tri-Service General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng Yao","family":"Cheng","sequence":"additional","affiliation":[{"name":"National Defense Medical Center"},{"name":"Tri-Service General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198306303082605"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.00006513"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13520"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2016.06.045"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.01.003"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27471"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.08.017"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/da.22894"}],"container-title":["Ear, Nose &amp; Throat Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613221129443","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01455613221129443","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613221129443","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:33:04Z","timestamp":1777401184000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01455613221129443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":8,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1177\/01455613221129443"],"URL":"https:\/\/doi.org\/10.1177\/01455613221129443","relation":{},"ISSN":["0145-5613","1942-7522"],"issn-type":[{"value":"0145-5613","type":"print"},{"value":"1942-7522","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10]]}}}