Vocal Cord Dysfunction: Etiologies and Treatment

@article{Morris2006VocalCD,
  title={Vocal Cord Dysfunction: Etiologies and Treatment},
  author={Michael J. Morris and Patrick F. Allan and Patrick J. Perkins},
  journal={Clinical Pulmonary Medicine},
  year={2006},
  volume={13},
  pages={73-86}
}
Vocal cord dysfunction, a syndrome of paradoxical inspiratory closure of the vocal cords, is becoming more frequently recognized and diagnosed recently since its initial modern description 30 years ago. Initially described as single case reports, the first case series in 1983 helped to clarify the typical patient and findings of vocal cord dysfunction. Recent investigations have elucidated specific etiologies such as gastroesophageal reflux, exercise, and irritants as causative factors in… 
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Key clinical features, important physical exam findings and commonly reported triggers in patients with vocal cord dysfunction are described, which can serve to differentiate the two conditions.
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The case of a 41-year old female referred to Allergology clinics with the diagnosis of asthma is reported, and thorough investigation revealed VCD as the cause of symptoms.
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TLDR
Being aware of the condition is key to avoid misdiagnosis in vocal cord dysfunction, and Fiberoptic laryngoscopy is the diagnostic gold standard to demonstrate paradoxical vocal cord adduction during an attack.
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TLDR
Given its complex nature, a multidisciplinary approach to VCD evaluation and management is necessary and results in optimal outcomes.
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TLDR
Speech therapy, including the use of special relaxed-throat breathing patterns is effective for VCD that is purely of the functional nature, and knowledge of the clinical features of VCD and identifying factors that may be contributing to the development can provide adequate clues to the correct diagnosis and management.
Vocal cord dysfunction/paradoxical vocal fold motion.
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References

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TLDR
Clues that should raise clinical suspicion to the diagnosis of vocal cord dysfunction include lack of response to bronchodilators, poor reproducibility of spirometric indices due to inconsistent effort and truncation of the inspiratory limb of the flow-volume loop.
Vocal cord dysfunction: the importance of psychologic factors and provocation challenge testing.
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TLDR
Therapy of VCD involves removal of unnecessary medications, efforts to minimize vocal cord irritation, and aggressive speech therapy, and in selected cases, anxiolytic medications and psychiatric consultation may be beneficial.
Vocal cord dysfunction masquerading as bronchial asthma.
TLDR
Therapy of VCD involves removal of unnecessary medications, efforts to minimize vocal cord irritation, and aggressive speech therapy, and in selected cases, anxiolytic medications and psychiatric consultation may be beneficial.
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TLDR
Results of evaluation, including pulmonary function tests, suggest discrete dysfunction localized to the neuromuscular pathway responsible for vocal cord abduction in three siblings in one family.
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Stridor Caused by Vocal Cord Malfunction Associated with Emotional Factors
TLDR
Two adolescent patients in whom a disorder of the vocal cords associated with emotional factors resulted in acute episodes of stridor are described, and the importance of diagnosing these functional problems in children is emphasized.
Vocal cord dysfunction during wartime.
TLDR
A high level of suspicion for VCD is essential to make the diagnosis so as to avoid unnecessary, potentially toxic medications and to direct the patient to prompt psychiatric care, which along with speech therapy is the cornerstone of care.
Childhood Sexual Abuse in Patients with Paradoxical Vocal Cord Dysfunction
TLDR
A history of childhood sexual abuse is identified as an important factor contributing to the development of this psychosomatic disorder that mimics those of bronchial asthma attacks.
Inspiratory vocal cord dysfunction, a new approach in treatment.
TLDR
This work uses an innovative approach which requires relatively inexpensive and simple anaesthetic equipment in order to manipulate airways resistance and thus reduce any vocal cord dysfunction as it occurs.
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