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Published on: December 1, 2023
Paradoxical vocal cord dysfunction: clinical experience and personal considerations.
1Department of Neurosciences, Audiology and Phoniatric Unit, Pisa University, Italy. a.nacci@med.unipi.it
Summary
Paradoxical vocal cord dysfunction (PVCD) causes sudden breathing difficulty. Diagnosis requires suspicion and laryngoscopy, with speech therapy showing promising results for respiratory retraining.
Area of Science:
- Otolaryngology
- Pulmonology
- Psychiatry
Background:
- Paradoxical vocal cord dysfunction (PVCD) is a complex condition with unclear diagnostic criteria and etiology.
- PVCD presents with recurrent episodes of acute dyspnea, often accompanied by hoarseness, globus sensation, chest pain, and shortness of breath.
Observation:
- A retrospective analysis identified 3 patients with PVCD among those referred for acute dyspnea.
- Two patients had co-occurring psychiatric morbidity, and one had gastro-esophageal reflux.
- In one case, dyspnea was triggered by inhaled irritants.
Findings:
- High clinical suspicion is crucial for diagnosing PVCD.
- Laryngoscopy confirming true vocal cord hyperadduction and a >50% reduction in breathing space is diagnostic.
- Associated conditions like psychiatric disorders and GERD may be present.
Implications:
- A multidisciplinary approach involving various specialists is essential for effective PVCD management.
- Speech therapy focusing on respiratory and speech retraining offers a viable therapeutic option.
- Further research is needed to fully elucidate PVCD's pathogenesis and diagnostic standards.
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