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[Vocal cord dysfunction. An important differential diagnosis to bronchial asthma]
C Kothe1, G Schade, S Fleischer
1Poliklinik für Hör-, Stimm- und Sprachheilkunde des Universitätsklinikums Hamburg-Eppendorf, Hamburg. c.kothe@uke.uni-hamburg.de
HNO
|March 10, 2004
Summary
Vocal cord dysfunction (VCD) causes shortness of breath by paradoxically closing the glottis during inhalation. Treatment tailored to the cause, including therapy or medication, effectively reduced VCD attacks in three women.
Area of Science:
- Otolaryngology
- Pulmonology
- Functional Voice Disorders
Background:
- Vocal cord dysfunction (VCD) is a functional disorder characterized by paradoxical glottic closure during inspiration.
- It often presents with symptoms mimicking asthma, leading to misdiagnosis.
- Understanding VCD's diverse etiologies is crucial for effective management.
Observation:
- Three women experienced recurrent episodes of shortness of breath attributed to VCD.
- Diagnosis was confirmed via transnasal videofiberendoscopy, visualizing inspiratory glottic closure.
- Individualized treatment approaches were employed based on suspected underlying causes.
Findings:
- One patient received breathing and speech therapy.
- Another was treated with Omeprazol for laryngopharyngeal reflux.
- The third patient underwent intralaryngeal botulinum toxin injections.
- All three patients demonstrated a significant reduction in VCD-related attacks post-treatment.
Implications:
- VCD can present clinically similar to asthma, highlighting the need for accurate diagnostic methods.
- Transnasal laryngoscopy, particularly during a triggered attack, is essential for precise VCD diagnosis.
- Tailored therapeutic strategies based on etiology can effectively manage VCD and improve patient outcomes.