Vocal cord dysfunction as a differential diagnosis of an asthma exacerbation and uncontrolled asthma. A case report and review of the literature

Disfunción de cuerdas vocales como diagnóstico diferencial de una crisis asmática y asma no controlada. Descripción de un caso y revisión de la literatura

Vocal fold dysfunction (VCD) is a pathology characterized by paroxysmal and involuntary episodes of adduction of the vocal folds during inspiration. In severe cases, it obstructs the central airway, causing dyspnea and stridor. This disorder is related to multiple etiologies, such as neurological disorders, gastroesophageal reflux, psychogenic disorders, allergic rhinitis, and asthma, among others.

VCD occurs in women between 20 and 45 years of age. However, it also includes preschool children, schoolchildren, and adults. Laryngeal dysfunction can be confused with asthma, acute respiratory disorders, or laryngeal problems. The diagnosis is usually made after excluding other pathologies by performing forced spirometry and direct vision of the paradoxical movement of the vocal folds during inspiration by fiberoptic bronchoscopy (FBC).

We present the case of a patient who consulted because of cough, dyspnea, and wheezing refractory to bronchodilator management, where the studies carried out helped to rule out infectious/bronchial obstructive pathology and showed the diagnosis of VCD.