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Related Experiment Videos

Vocal cord dysfunction induced by methacholine challenge testing.

Patrick J Perkins1, Michael J Morris

  • 1Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, 3581 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200, USA. Patrick.Perkins@cen.amedd.army.mil

Chest
|December 12, 2002
PubMed
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Methacholine challenge testing (MCT) can provoke vocal cord dysfunction (VCD) in some patients, causing inspiratory vocal cord closure. However, spirometry and flow-volume loops (FVLs) changes after MCT are not always diagnostic of VCD.

Area of Science:

  • Pulmonology
  • Laryngology
  • Diagnostic Testing

Background:

  • Vocal cord dysfunction (VCD) can mimic asthma symptoms.
  • Methacholine challenge testing (MCT) is used to diagnose reactive airway disease.

Purpose of the Study:

  • To investigate if MCT provokes VCD.
  • To assess if spirometry and flow-volume loops (FVLs) show changes indicative of VCD post-MCT.

Main Methods:

  • Prospective, controlled study involving 34 subjects.
  • Subjects included those with VCD, exercise-induced asthma (EIA), and healthy controls.
  • Spirometry, FVLs, and direct laryngoscopy were performed before and after MCT.

Main Results:

  • Four VCD patients showed inspiratory vocal cord adduction post-MCT.

Related Experiment Videos

  • Two VCD patients developed acute inspiratory vocal cord adduction after MCT.
  • Inspiratory FVL truncation occurred in 60% of patients with VCD evidence post-MCT.

    • Conclusions:

    • MCT may acutely induce vocal cord adduction.
    • Positive MCT results may not always indicate underlying reactive airways disease.
    • Inspiratory FVL flattening post-MCT is not a definitive diagnostic marker for VCD.