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
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Vocal fold dysfunction (VCD) is a pathology characterized by paroxysmal and involuntary episodes of adduction of the vocal folds during inspiration and in severe cases it presents as an obstruction of the central airway causing dyspnea and stridor (1). This disorder is related to multiple etiologies, such as neurological disorders, gastroesophageal reflux, psychogenic disorders, allergic rhinitis, asthma, among others (2). VCD occurs predominantly in women between 20 to 45 years of age, however, it also includes preschool children, schoolchildren (3) and adults. Laryngeal dysfunction can be confused with asthma, acute respiratory disorders, or laryngeal problems (4). The diagnosis is usually made after the exclusion of 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 established the diagnosis of VCD.
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- Christopher KL WRER et al. Vocal - cord dysfunction presenting as asthma. N Engl J Med . Doi: 1983;26:1566–70.
- Leong P, Vertigan AE, Hew M, Baxter M, Phyland D, Hull JH, et al. Diagnosis of vocal cord dysfunction/inducible laryngeal obstruction: an International Delphi Consensus Study. Journal of Allergy and Clinical Immunology. 2023 Oct 1; Doi: 10.1016/j.jaci.2023.06.007.
- Newman KB, Mason UG, Schmaling KB. Brief Communications Clinical Features of Vocal Cord Dysfunction. 1995. Doi: 10.1164/ajrccm.152.4.7551399.
- Petrov AA. Vocal Cord Dysfunction: The Spectrum Across the Ages. Vol. 39, Immunology and Allergy Clinics of North America. W.B. Saunders; 2019. p. 547–60. Doi: 10.1016/j.iac.2019.07.008.
- Traister RS, Fajt ML, Whitman-Purves E, Anderson WC, Petrov AA. A retrospective analysis comparing subjects with isolated and coexistent vocal cord dysfunction and asthma. Allergy Asthma Proc. 2013 Jul;34(4):349–55. Doi: 10.2500/aap.2013.34.3673.
- Christensen PM, Heimdal JH, Christopher KL, Bucca C, Cantarella G, Friedrich G, et al. ERS/ELS/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions. Vol. 24, European Respiratory Review. European Respiratory Society; 2015. p. 445–50. Doi: 10.1183/16000617.00006513.
- Cohen SM. The Journal for Nurse Practitioners-JNP 675 Diagnosis and Management of Vocal Cord Dysfunction [Internet]. 2010. Available from: www.npjournal.org. Doi: 10.1016/j.nurpra.2010.04.004.
- Forrest LA, Husein T, Husein O. Paradoxical vocal cord motion: Classification and treatment. Laryngoscope. 2012 Apr;122(4):844–53. Doi: 10.1002/lary.23176.
- Chacón RA, González LJ, Montalbán CR. Manejo de la vía aérea en procedimientos de la vía aérea superior. Vol. 39, Rev Chil Anest. 2010. Doi: 10.30789/rcneumologia.v26.n2.2014.46
- Kaminsky DA, Simpson SJ, Berger KI, Calverley P, de Melo PL, Dandurand R, et al. Clinical significance and applications of oscillometry. Vol. 31, European Respiratory Review. European Respiratory Society; 2022. Doi: 10.1183/16000617.0208-2021.
- Santos GD, Gustavo ) ;, Hincapié A, Ordóñez J, Awad C. Impulse oscillometry in adults: a complementary lung function test. Vol. 26, Revista Colombiana de Neumología. 2014.
- Hira HS, Singh A. Signifi cance of upper airway infl uence among patients of vocal cord dysfunction for its diagnosis: Role of impulse oscillometry [Internet]. Vol. 26, Lung India 2009. Available from: http://journals.lww.com/lungindia. Doi: 10.4103/0970-2113.45197.
- Bisdorff B, Kenn K, Nowak D, Schlichtiger J, Bäuml J, Orban E, et al. Asthma and vocal cord dysfunction related symptoms in the general population - A pilot study. Annals of Allergy, Asthma and Immunology. 2014 Nov 1;113(5):576–7. Doi: 10.1016/j.anai.2014.08.009.
- Kramer S, deSilva B, Forrest LA, Matrka L. Does treatment of paradoxical vocal fold movement disorder decrease asthma medication use? Laryngoscope. 2017 Jul 1;127(7):1531–7. Doi: 10.1002/lary.26416.
- Baxter M, Ruane L, Phyland D, Leahy E, Heke E, Lau KK, et al. Multidisciplinary team clinic for vocal cord dysfunction directs therapy and significantly reduces healthcare utilization. Respirology. 2019 Aug 1;24(8):758–64. Doi: 10.1111/resp.13520.
- Drake K, Palmer AD, Schindler JS, Tilles SA. Functional Outcomes after Behavioral Treatment of Paradoxical Vocal Fold Motion in Adults. Folia Phoniatrica et Logopaedica. 2018 Mar 1;69(4):154–68. Doi: 10.1159/000484716.
- Shaffer M, Litts JK, Nauman E, Haines J. Speech-Language Pathology as a Primary Treatment for Exercise-Induced Laryngeal Obstruction. Vol. 38, Immunology and Allergy Clinics of North America. W.B. Saunders; 2018. p. 293–302. Doi: 10.1016/j.iac.2018.01.003.
- Ruotsalainen JH, Sellman J, Lehto L, Jauhiainen M, Verbeek JH. Interventions for treating functional dysphonia in adults. Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd; 2007. Doi: 10.1002/14651858.CD006373.pub2.
- Casper JK, Murry T. Voice therapy methods in dysphonia. Otolaryngol Clin North Am. 2000 Oct;33(5):983-1002. doi: 10.1016/s0030-6665(05)70259-0..