[Vocal cord dysfunction in children and adolescents]

More attention has been given to vocal cord dysfunction (VCD) in the past years. Even though the disease is known since 1983 and was brought to mind at least casuistically through the years, often VCD was not diagnosed as such, being mistaken for bronchial asthma - at times with grave consequences for the patient. VCD causes the acute onset of stridulous respiration with acute dyspnea making the differential diagnosis of asthma quite suggestive. The inspirational stridor and a peracute progression of the disease should cause doubts as to the diagnosis of asthma. We collected case reports and describe the symptoms and diagnostic approaches to VCD as well as showing discriminating findings towards bronchial asthma. We report on five children suffering from VCD (4 girls, 1 boy) aged from 2 to 13 years. It could be shown that VCD is caused by a multifactoral pathomechanism, which has both somatic and psychological aspects. A surprising find was that all of the children were diagnosed with a pathological gastroesophageal reflux, partly in serious dimensions, without showing the typical symptoms such as retrosternal pain, stomach-ache or recurrent vomiting (so called silent reflux). Since there is a multitude of pathomechanisms involved and the disease often coincides with allergic asthma, an individual therapy plan is needed for each patient.