It can be clinically difficult to distinguish asthma from paradoxical vocal fold motion (PVFM), also called vocal cord dysfunction (VCD). This matters because the treatment course is different for each disorder. Treatment for asthma for example, may have no effect on PVFM/VCD, or even could make breathing symptoms worse. A journal article titled “A Novel Scoring System to Distinguish Vocal Cord Dysfunction from Asthma” aims to further delineate the two. http://goo.gl/3XcNLr.
The research team developed the Pittsburgh VCD (Vocal Cord Dysfunction) Index. They found that symptoms of throat tightness and dysphonia (change in voice), absence of wheezing, and the presence of odors as a symptom trigger were specific predictive features of paradoxical vocal fold motion/vocal cord dysfunction that distinguish it from asthma. However, no distinguishing features between PVFM/VCD and asthma could be found when these disorders co-exist, which is not uncommon.
More specifics are available from the UPMC website http://goo.gl/g21W4G. PVFM/VCD can often be mistaken for exercise-induced asthma (EIA) but there are subtle differences in their symptoms:
|
VCD |
Exercise-Induced Asthma |
|
Symptoms occur shortly after beginning exercise |
Symptoms occur later in exercise |
|
Tightness in throat |
Tightness in middle or lower chest |
|
Difficulty inhaling |
Difficulty exhaling |
|
Hoarseness |
N/A |
|
Albuterol inhaler doesn’t control symptoms |
Albuterol inhaler controls symptoms |
|
Symptoms recur immediately when resuming exercise after Albuterol treatment |
Symptoms are less severe when exercise is resumed after Albuterol treatment |
|
Recovery time is less than 10 minutes |
Recovery takes up to an hour without medication |
Treatment options for PVFM/VCD may include:
- Reflux medications or dietary changes to reduce reflux
- Use of nasal sprays or saline nasal rinses for post-nasal drip
- Speech therapy to learn breathing techniques to relax the vocal cords
- If anxiety is a trigger, anxiety treatment may be helpful
PVFM/VCD responds well to speech therapy with emphasis on education, and restoring and maintaining open airway posture throughout symptomatic episodes. Contact Voicetrainer LLC for further questions or to schedule an appointment at info@voicetrainer.com or 202-580-6646.
