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

  • Emotional stress, anxiety, or panic attacks can trigger episodes of vocal cord dysfunction, leading to involuntary closure of the vocal cords during breathing.

  • Environmental factors, such as smoke, pollution, strong odors, or airborne allergens, can irritate the airways and trigger VCD.

  • Acid reflux from the stomach can irritate the throat and vocal cords, causing symptoms similar to asthma.

  • VCD triggered by exercise may mimic symptoms of exercise-induced asthma in some individuals.

  • 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

  • Breathing difficulties: Tightness or constriction in the throat, difficulty inhaling or exhaling, or feeling short of breath.

  • A high-pitched whistling sound that occurs during breathing, similar to asthma. Wheezing occurs more during inhalation than during exhalation in VCD.

  • Tightness in the throat, sensation of choking or suffocation, or feeling of a lump in the throat.

  • Voice quality changes, such as hoarseness or voice breaks, may occur during episodes of VCD.

  • In the absence of respiratory infections or other underlying lung conditions, coughing is considered chronic or recurrent.

  • 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:

  • A healthcare provider will ask about symptoms, triggers, frequency of episodes, and any underlying medical conditions.

  • The physical examination may reveal signs of respiratory distress, abnormal breathing patterns, or changes in voice quality indicative of VCD.

  • During laryngoscopy, a flexible or rigid endoscope is used to view the vocal cords to detect abnormalities.

  • 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.

  • 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:

  • Techniques such as diaphragmatic breathing, pursed lip breathing, or inspiratory muscle training can help control symptoms and improve breathing efficiency during VCD episodes.

  • Vocal cord exercises or speech therapy can help retrain the vocal cords and improve coordination of breathing and voice production.

  • Using relaxation exercises, mindfulness meditation, or cognitive-behavioral therapy (CBT) can help reduce anxiety and minimize triggers for VCD.

  • VCD episodes can be prevented by avoiding triggers such as smoke, pollution, strong odors, or allergens.

  • To manage symptoms or treat underlying conditions contributing to VCD, medications such as inhaled bronchodilators, corticosteroids, or antireflux medications may be prescribed.

  • Reduce symptoms of VCD by minimizing exposure to irritants such as cigarette smoke, air pollution, or chemical fumes.

Prevention

  • In order to prevent VCD episodes, it is important to identify and avoid triggers such as stress, anxiety, allergens, pollutants, or strong odors.

  • Practicing relaxation exercises, meditation, or yoga can help reduce anxiety and minimize VCD triggers.

  • 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.

  • VCD triggers can be minimized by improving indoor air quality, such as using air purifiers or avoiding indoor pollutants.

  • Regular exercise, balanced nutrition, adequate sleep, and stress management can help support overall respiratory health and reduce the risk of VCD.