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Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
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Vocal Cord Dysfunction: Rapid Evidence Review.

John Malaty1, Velyn Wu1

  • 1University of Florida, Gainesville, FL, USA.

American Family Physician
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Summary
This summary is machine-generated.

Vocal cord dysfunction (VCD) causes airway obstruction, mimicking asthma. Suspect VCD in patients with inspiratory stridor, dyspnea, or throat tightness, especially in females. Therapeutic breathing and relaxation techniques are key treatments.

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Area of Science:

  • Pulmonology
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Vocal cord dysfunction (VCD) involves abnormal vocal cord closure during inspiration, presenting as inspiratory stridor or wheezing.
  • It can be mistaken for asthma, but lacks hypoxia or increased work of breathing.
  • Common triggers include exercise, asthma, GERD, postnasal drip, infections, and irritants.

Purpose of the Study:

  • To outline the clinical presentation, triggers, diagnostic methods, and management of vocal cord dysfunction.
  • To differentiate VCD from other respiratory conditions.
  • To review therapeutic approaches for VCD-induced dyspnea and dysphonia.

Main Methods:

  • Clinical presentation review, including symptoms like inspiratory stridor, dyspnea, and throat tightness.
  • Diagnostic evaluation using nasolaryngoscopy and pulmonary function tests with provocative maneuvers (exercise, methacholine).
  • Assessment of treatment strategies including trigger management, breathing exercises, and pharmacologic interventions.

Main Results:

  • VCD should be suspected in specific patient demographics and symptom profiles, particularly in females.
  • Nasolaryngoscopy and provocative PFTs aid diagnosis and differential diagnosis.
  • Optimal treatment of underlying conditions (asthma, GERD, postnasal drip) and avoidance of irritants are crucial.

Conclusions:

  • Therapeutic breathing maneuvers and vocal cord relaxation are first-line treatments for VCD-related dyspnea.
  • A subset of VCD presents with dysphonia due to laryngeal muscle spasms.
  • OnabotulinumtoxinA may offer benefits for spasmodic dysphonia and refractory dyspnea, though evidence is limited.