Vocal Cord Dysfunction (VCD)

Vocal cord dysfunction was first described over 150 years ago by a person by the name of Dunglison who called it "an affection of the laryngeal muscles". However, it was not until the last 1980's that more cases were reported. The vocal cords are a group of tissue found in the throat used to create sound. During normal breathing the vocal cords remain in the open position. Patients with vocal cord dysfunction have a paradoxical, or opposite, motion of the vocal cords causing them to remain closed during normal breathing.

What causes VCD?

The exact cause of VCD is not known and it is believed to be an involuntary closure of the vocal cords which may produce wheezing, a sensation of shortness of breath, and seen in patients either with or without asthma. One study done at the National Center for Immunology and Respiratory Medicine in Denver, a major referral center for asthma patients, showed that 40 percent of their very serious asthmatics had VCD. Specifically, 10% had isolated VCD and 30% had asthma and VCD.

How do you diagnose VCD?

Your diagnosis will be made with your history, physical exam, changes in the shape of your breathing test, and most importantly visualizing the motion of your vocal cords with a small flexible light called a nasal endoscope. Your doctor will explain the procedure to you in detail.

Does this mean that I do not have asthma?

Because VCD may be seen with and without asthma you should not stop your asthma medication if you are diagnosed with VCD. Your doctor will have to formulate a careful plan to decided whether to continue your asthma medication or slowly wean you off over several weeks to months.

How do you treat VCD?

Initial treatment will include intensive speech therapy with a person trained in treating this condition. This includes abdominal breathing and panting exercises to help relax the vocal cords and treat acute and future episodes of VCD. In the event that this fails, other therapy may include medication(s) or behavioral modification.

What is my prognosis?

Most patients with VCD once diagnosed do very well if they undergo the appropriate therapy. Most short term studies in the medical literature report a high percentage of patients who seem to achieve resolution of their symptoms.