Vocal cord dysfunction

Vocal cord dysfunction (VCD) is a pathology affecting the vocal folds (commonly referred to as the vocal cords) characterized by full or partial vocal fold closure causing difficulty and distress during respiration, especially during inhalation. Due to the similarity in symptoms, VCD attack are often mistaken for asthma attacks or laryngospasms. Symptoms of VCD are not always present. Rather, they often occur episodically, often defined as "attacks," where the patient will be symptomatic for a short period of time. Although several contributing factors have been identified, the exact cause of VCD is unknown. Diagnosis of VCD may include a series of evaluations including pulmonary function tests, medical imaging, and the evaluation or visualization of the vocal folds during an episode through the use of videolaryngoscopy. Such evaluations can also help to rule out other conditions that can affect the upper and lower airway. Treatment of VCD often combines behavioural, medical and psychological approaches, most often including an otolaryngologist, a psychologist, and a speech-language pathologist. Although information on the incidence and prevalence of VCD is limited, it is known to occur most frequently in young women. Many of the symptoms are not limited to the disorder, as they may resemble a number of conditions that affect the upper and lower airway. Such conditions include asthma, angioedema, vocal cord tumors, and vocal cord paralysis. People with vocal cord dysfunction often complain of "difficulty in breathing in" or "fighting for breath", which can lead to subjective respiratory distress, and in severe cases, loss of consciousness. They may report tightness in the throat or chest, choking, stridor on inhalation and wheezing, which can resemble the symptoms of asthma. These episodes of dyspnea can be recurrent and symptoms can range from mild to severe and prolonged in some cases. Agitation and a sense of panic are not uncommon and can result in hospitalization. Different subtypes of vocal cord dysfunction are characterized by additional symptoms.