Vocal Cord Dysfunction

Description

• Vocal cord dysfunction (VCD): a breathing disorder in which vocal cords adduct inappropriately. This occurs primarily on inspiration and produces airflow obstruction that may result in dyspnea, wheezing, and stridor.
• Synonym(s): paradoxical vocal fold motion (PVFM)

Epidemiology

Incidence
Not well defined

Prevalence

• Unknown; likely uncommon in the general population
• Most frequently diagnosed in patients evaluated for asthma and exercise-induced dyspnea
• Female predominance, 2:1 (1)
• 71% of patients are adults and 29% of patients <18 years of age; also, has been diagnosed in young children/infants (1)
• Suspect occurrence in approximately 3% of intercollegiate athletes with exercise-induced asthma (2).

Etiology and Pathophysiology

• Exact etiology is unclear—both organic and nonorganic causes have been identified.
• Possible laryngeal hyperresponsiveness to irritants, such as smoke, dust, postnasal drip, gastroesophageal reflux disease (GERD), URI, or other irritants (3)
• Noncompetitive and competitive exercises—unknown mechanism (4)
• Psychological factors such as anxiety, severe social stresses (e.g., competitive sports), history of sexual abuse (2)

Genetics
None defined

Risk Factors

See “Commonly Associated Conditions.”

Commonly Associated Conditions

• Asthma
• GERD
• Rhinosinusitis
• Psychological conditions such as posttraumatic stress disorder, anxiety, depression, and panic disorder