Vocal Cord Dysfunction ( VCD ): Overview
To understand vocal cord dysfunction (VCD) [or paradoxical vocal fold motion (PVFM)], it is helpful to understand how the vocal cords function. The vocal cords are located at the top of the windpipe (trachea) and vibrate from exhaled air to produce noise and voice. Breathing causes the vocal cords to open, allowing air to flow through the windpipe (trachea) and into the lungs. With VCD, the vocal cords close together, or constrict, during inhalation or exhalation. This leaves only a small opening for air to flow through the windpipe and causes asthma-like symptoms.
History of VCD
The discovery of VCD/PVFM is relatively new. It first appeared in medical literature in 1951 and was characterized as a symptom of “lying” by the patient. Through the years, VCD has had many names, including factitious asthma, mimicking asthma, irritable larynx and laryngeal dysfunction.
In 1983, a group of patients who were said to have “uncontrolled asthma”, were seen at National Jewish Health for evaluation. A multidisciplinary team of medical professionals including pulmonologists, otolaryngologists, psychiatrists and speech-language pathologists were able to accurately identify the condition and provided treatment for what we now know as VCD.
Diagnosis of VCD
A detailed evaluation is needed to correctly identify vocal cord dysfunction (VCD) [or paradoxical vocal fold motion (PVFM)] and determine effective methods of treatment.
Ways to diagnose VCD include:
• Laryngoscopy : A flexible scope is used to view movement of the vocal cords when a patient is symptomatic
• Spirometry : Measurements are taken of airflow during respirations
•Clinical Evaluation: Detailed information is obtained from patients
Based on the symptoms of VCD, people may be misdiagnosed and treated for asthma alone. It is important to note that asthma and VCD may co-exist. Some people with VCD don’t have asthma. Different treatments will be effective for VCD and asthma.
Symptoms of VCD
The primary reason vocal cord dysfunction (VCD) [or paradoxical vocal fold motion (PVFM)] is confused with asthma is because the two respiratory diseases share similar symptoms.
Patients with VCD may experience the following symptoms:
•Shortness of breath
•Chest and/or throat tightness
•Frequent throat clearing
•Difficulty with inhalation and/or exhalation
•Feeling they are “breathing through a straw”
*Constant feeling of Lump in your throat