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Vocal cord dysfunction mimics asthma and may respond to heliox
1Department of Pediatrics, Scott & White Clinic and Memorial Hospital, Scott, Sherwood and Brindley Foundation, Texas A&M University Health Science Center, College of Medicine, Temple, 76508, USA.
Clinical Pediatrics
|February 28, 2002
Summary
Vocal cord dysfunction (VCD) causes wheezing mistaken for asthma. Heliox inhalation offers rapid relief for VCD symptoms, complementing voice training for long-term management.
Area of Science:
- Pulmonology
- Laryngology
Background:
- Vocal cord dysfunction (VCD) is an underdiagnosed cause of wheezing that can mimic asthma.
- VCD involves involuntary adduction of vocal cords during inspiration, causing characteristic wheezing.
- Standard asthma therapies are ineffective for VCD and can cause harm.
Observation:
- Diagnosis requires direct visualization of vocal cord adduction during an episode via endoscopy.
- Heliox, a mixture of helium and oxygen, has been used anecdotally to alleviate VCD symptoms.
- A retrospective review examined heliox use in adolescent patients with VCD.
Findings:
- Four out of five adolescent patients with VCD experienced significant symptom improvement with heliox therapy.
- Heliox administration resulted in reduced wheezing and decreased patient anxiety.
- No complications were reported during heliox treatment for VCD.
Implications:
- A high index of suspicion is crucial for accurate VCD diagnosis, preventing unnecessary asthma treatments.
- Heliox inhalation may serve as a valuable adjunctive therapy for symptomatic VCD, similar to reliever inhalers for asthma.
- Heliox could reduce emergency visits for VCD, while speech therapy provides definitive management.