In vocal cord dysfunction (VCD), also known as paradoxical vocal fold movement (PVFM), the vocal cords move abnormally during breathing, causing symptoms like wheezing, throat tightness, and difficulty breathing. This is a straightforward breakdown of its causes, symptoms, diagnosis, treatment, and prevention.
Causes
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Emotional stress, anxiety, or panic attacks can trigger episodes of vocal cord dysfunction, leading to involuntary closure of the vocal cords during breathing.
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Environmental factors, such as smoke, pollution, strong odors, or airborne allergens, can irritate the airways and trigger VCD.
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Acid reflux from the stomach can irritate the throat and vocal cords, causing symptoms similar to asthma.
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VCD triggered by exercise may mimic symptoms of exercise-induced asthma in some individuals.
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VCD can be caused by neurological conditions such as Parkinson's disease, multiple sclerosis, or brainstem lesions that disrupt normal control of the vocal cords.
Symptoms
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Breathing difficulties: Tightness or constriction in the throat, difficulty inhaling or exhaling, or feeling short of breath.
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A high-pitched whistling sound that occurs during breathing, similar to asthma. Wheezing occurs more during inhalation than during exhalation in VCD.
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Tightness in the throat, sensation of choking or suffocation, or feeling of a lump in the throat.
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Voice quality changes, such as hoarseness or voice breaks, may occur during episodes of VCD.
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In the absence of respiratory infections or other underlying lung conditions, coughing is considered chronic or recurrent.
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Symptoms of VCD may be exacerbated by feelings of anxiety, panic, or stress.
Diagnosis
Medical history review, physical examination, and diagnostic tests are typically used to diagnose vocal cord dysfunction:
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A healthcare provider will ask about symptoms, triggers, frequency of episodes, and any underlying medical conditions.
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The physical examination may reveal signs of respiratory distress, abnormal breathing patterns, or changes in voice quality indicative of VCD.
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During laryngoscopy, a flexible or rigid endoscope is used to view the vocal cords to detect abnormalities.
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Spirometry and peak expiratory flow (PEF) measurements are pulmonary function tests that are performed to assess lung function and rule out asthma and other respiratory conditions.
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Exercise challenge tests or exposure to suspected triggers can be used to reproduce symptoms and confirm a diagnosis of VCD.
Treatment
Vocal cord dysfunction is treated by managing symptoms, reducing triggers, and addressing underlying factors:
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Techniques such as diaphragmatic breathing, pursed lip breathing, or inspiratory muscle training can help control symptoms and improve breathing efficiency during VCD episodes.
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Vocal cord exercises or speech therapy can help retrain the vocal cords and improve coordination of breathing and voice production.
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Using relaxation exercises, mindfulness meditation, or cognitive-behavioral therapy (CBT) can help reduce anxiety and minimize triggers for VCD.
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VCD episodes can be prevented by avoiding triggers such as smoke, pollution, strong odors, or allergens.
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To manage symptoms or treat underlying conditions contributing to VCD, medications such as inhaled bronchodilators, corticosteroids, or antireflux medications may be prescribed.
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Reduce symptoms of VCD by minimizing exposure to irritants such as cigarette smoke, air pollution, or chemical fumes.
Prevention
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In order to prevent VCD episodes, it is important to identify and avoid triggers such as stress, anxiety, allergens, pollutants, or strong odors.
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Practicing relaxation exercises, meditation, or yoga can help reduce anxiety and minimize VCD triggers.
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The use of speech therapy or vocal cord exercises can improve the function of the vocal cords and reduce the frequency and severity of VCD episodes.
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VCD triggers can be minimized by improving indoor air quality, such as using air purifiers or avoiding indoor pollutants.
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Regular exercise, balanced nutrition, adequate sleep, and stress management can help support overall respiratory health and reduce the risk of VCD.
