Ask a Doctor: Vocal Cord Dysfunction

Introducing: Ask a Doctor

At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.

That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.

Today, we highlight vocal cord dysfunction.

Prepared by: Jessica Bertram
Reviewed by: Dr. Sandra Stinnett

What is vocal cord dysfunction?

During normal inhalation, the vocal cords remain open and allow air into the lungs. In individuals with vocal cord dysfunction (VCD), the vocal cords close or narrow inappropriately, making it difficult to breath for a transient period of time.

Often, VCD is misdiagnosed as asthma, allergies or other lung diseases.

Vocal cord dysfunction includes a spectrum of functional vocal fold pathology including Inducible Laryngeal Obstruction (ILO) or Paradoxical Vocal Fold Motion (PVFM).

What causes vocal cord dysfunction?

Vocal cord dysfunction occurs in response to a variety of triggers.

These include:

• Exercise
• Upper respiratory infection
• Acid reflux
• Having a breathing tube removed
• Strong odors or fumes
• Smoke
• Stress

VCD can also occur in the absence of these triggers.

What are its symptoms?

Some of the most common symptoms associated with vocal cord dysfunction include:

• Difficulty breathing
• Stridor or Noise Breathing
• Throat tightness
• Cough
• Feeling like you are choking
• Trouble speaking
• Hoarseness

Typically, symptoms last a short period of time.

What are some solutions I can try at home?

To minimize episodes of vocal cord dysfunction, individuals should try to avoiding potential triggers.

However, if experiencing an episode of vocal cord dysfunction, it can be helpful to perform modified respiratory techniques like panting (taking breaths in through the nose and out through pursed lips) in order to help open your vocal cords.

When should I see my doctor?

If you have difficulty breathing you should see your healthcare provider.

Since vocal cord dysfunction and asthma present with many of the same causes and symptoms, it is important to rule out asthma or other lung problems. Asthma requires certain medications that are not helpful in treating vocal cord dysfunction. Therefore, ruling out asthma–as well as other causes of breathing difficulty–is a necessary first step.

To help diagnose vocal cord dysfunction, your healthcare provider will have you undergo breathing tests which show you how much air you are getting into and out of your lungs. They may also use a small camera to look at your vocal cords in the back of your throat. Numbing medications are used on your nose and throat before the procedure to help with any discomfort.

Definitive diagnosis of vocal cord dysfunction is difficult challenging because the episode must be witnessed. Thus, your healthcare provider might attempt to trigger an episode while simultaneously looking at your vocal cords.

What are the treatment options?

Typically, episodes of vocal cord dysfunction stop on their own and are not relieved by medications.

That said, the main treatment for vocal cord dysfunction is a short course of respiratory retraining therapy with a speech and language therapy pathologist to train you to control your vocal cords.

Strategies during speech therapy often include:

• Patient education and counseling
• Respiratory retraining that focuses on ways to open vocal cords during an episode of vocal cord dysfunction
• Relaxation techniques for your throat muscles
• Deep breathing exercises
• Working on breathing pace

Individuals with vocal cord dysfunction experience great benefit from speech and language therapy with 75% to 80% experiencing complete resolution or improved symptoms.

Other treatments for VCD include treatment of underlying conditions (upper respiratory infection, acid reflux), continuous positive airway pressure (CPAP) or botulinum toxin injections in severe cases.

How can our Dream Team help?

UTHSC ENT’s Dream Team provides world class treatment in your hometown. In addition to our renowned Voice Box Doctor, Sandra Stinnett M.D., our team includes two certified speech pathologists. 

If you’re having any issue with your voice, UTHSC ENT should be your first call! 901-272-6051