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Vocal Cord Dysfunction

Vocal Cord Dysfunction is a topic covered in the 5-Minute Clinical Consult.

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Basics

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

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Citation

Stephens, Mark B., et al., editors. "Vocal Cord Dysfunction." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688218/all/Vocal_Cord_Dysfunction.
Vocal Cord Dysfunction. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688218/all/Vocal_Cord_Dysfunction. Accessed July 17, 2019.
Vocal Cord Dysfunction. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688218/all/Vocal_Cord_Dysfunction
Vocal Cord Dysfunction [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 July 17]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688218/all/Vocal_Cord_Dysfunction.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Vocal Cord Dysfunction ID - 1688218 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688218/all/Vocal_Cord_Dysfunction PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -