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Vocal cord dysfunction related to combat deployment.

Michael J Morris1, Ryan T Oleszewski, James B Sterner

  • 1Pulmonary/Critical Care Service, Department of Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234.

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Summary
This summary is machine-generated.

Combat stress and anxiety are common triggers for vocal cord dysfunction (VCD) in deployed military personnel. Early diagnosis using spirometry and methacholine challenge testing is recommended.

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Area of Science:

  • Pulmonology
  • Military Medicine
  • Psychiatry

Background:

  • Vocal cord dysfunction (VCD) presents with dyspnea and inspiratory stridor, but its predisposing factors remain unclear.
  • Combat stress has been previously identified as a potential psychiatric etiology for VCD.

Purpose of the Study:

  • To investigate the common etiologies and diagnostic approaches for VCD in military personnel post-deployment.
  • To identify factors contributing to the onset of VCD in a deployed military population.

Main Methods:

  • Retrospective review of military personnel diagnosed with VCD post-deployment at Landstuhl Regional Medical Center.
  • Analysis of medical records for pre-existing pulmonary, sinus, esophageal, or psychiatric disorders.
  • Evaluation of VCD diagnostic methods including spirometry and methacholine challenge testing.

Main Results:

  • Forty-eight patients with VCD post-deployment were identified.
  • Key triggers included high stress/anxiety (52%), exercise (39%), acute respiratory illness (16%), and trauma (7%).
  • A combination of abnormal flow volume loop and negative methacholine challenge yielded a 72% positive predictive value for VCD.

Conclusions:

  • Anxiety/stress and exercise are common etiologies for VCD onset during military deployment.
  • Spirometry with an abnormal flow volume loop and negative methacholine challenge testing provide reasonable diagnostic value for VCD.
  • Laryngoscopy is recommended for deployed military personnel with VCD and relevant findings to assess upper airway disorders.