Two cases of vocal cord dysfunction.
- Author:
Youngil I KOH
1
;
Inseon S CHOI
;
Seo Ung CHUNG
Author Information
1. Department of Allergy, Chonnam National University Medical School, Gwangju, Korea. yikoh@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Vocal cords;
Asthma
- MeSH:
Adrenal Cortex Hormones;
Airway Obstruction;
Asthma;
Bronchoscopy;
Cough;
Diagnosis;
Diagnostic Errors;
Dyspnea;
Early Diagnosis;
Humans;
Laryngoscopy;
Psychotherapy;
Respiratory Sounds;
Speech Therapy;
Spirometry;
Thorax;
Vocal Cord Dysfunction*;
Vocal Cords*
- From:Korean Journal of Medicine
2004;67(Suppl 3):S902-S907
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Vocal cord dysfunction (VCD), a condition that frequently mimics or confounds asthma, is characterized by a paradoxical adduction of the vocal cords on inspiration. The apposition of the vocal cords produces airflow obstruction sufficient to cause wheezing, chest tightness, shortness of breath, and cough. Misdiagnosis as asthma has led to inappropriate treatment, most notably with high-dose corticosteroids. Herein we report two cases of VCD who presented with chronic cough and episodic breathlessness, respectively. Flow-volume loops on spirometry were abnormal, with evidence of variable extrathoracic airway obstruction, manifested as flat or truncated inspiratory loops. Laryngoscopy or bronchoscopy demonstrated paradoxical adduction with posterior "chinking" of the vocal cords on inspiration. One case also had asthma and depressive illness. After the diagnosis of VCD, the clinical manifestations resolved with speech therapy and/or psychotherapy. VCD should be suspected in patients with asthma-like symptoms. An early diagnosis avoids unnecessary aggressive management.
