• HP Allergy and Asthma Specialists

Vocal Cord Dysfunction


What is Vocal Cord Dysfunction?

Vocal cord dysfunction (VCD) occurs when the vocal cords close when they should be open. Your vocal cords open to allow you to breathe in air. If the vocal cords close during inspiration this creates airflow obstruction. VCD can also be referred to as Paradoxical Vocal Fold Movement (PVFM). The most common symptoms of VCD are shortness of breath, hoarseness, voice changes, throat tightness, coughing, wheezing, and even chest tightness. Many of these symptoms are common in asthma. In fact, nearly 80% of VCD episodes are wrongly diagnosed as asthma. While asthma and VCD are 2 completely distinct conditions with different treatment methods, one can have both asthma and VCD and even have attacks of both at the same time. Difficult to control asthma that is not responding to typical asthma therapies can often be from coexisting VCD that is untreated.

What are the triggers for Vocal Cord Dysfunction?

While some people can have VCD with no identifiable trigger, many people can identify certain factors which seem to make an attack more likely. Some of the most common triggers include:

· Exercise

· Irritants such as perfumes, strong smells, fumes, cigarette smoke, chemical, and pollutants

· Stress and Anxiety

· Gastroesophageal reflux disease

· Infections such as colds, viral infections, and sinusitis

· Certain medications (mainly neuroleptic drugs such as phenothiazines)


How do you diagnose Vocal Cord Dysfunction?

VCD can sometimes be hard to diagnose, especially because symptoms are so similar to asthma. Thus, often it can take time between the onset of symptoms and the diagnosis of VCD. History and physical exam are always important in diagnosis. Then usually pulmonary function testing or spirometry will be performed. This is a breathing test that shows airflow in your lungs. It can screen for asthma but also can have some abnormalities in VCD. In some cases, a laryngoscopy will be recommended. This is a test using a camera to visualize your vocal cords while breathing.


How is Vocal Cord Dysfunction treated?


The main treatment for VCD involved speech therapy. Speech language pathologists who specialize in VCD can teach one breathing techniques. While the vocal cords move involuntarily, there are breathing exercises that can stop the paradoxical motion and spasms seen in VCD. Approximately 90% of patients with VCD improve with speech therapy. Some patients with VCD have known triggers. Trying to decrease exposure to or control certain triggers can also aid in treatment of VCD.