What is Vocal Cord Dysfunction?
Vocal cord dysfunction is a generalized term used to describe a neuropathy in the vagus nerve that causes a feeling of constantly having a lump in one’s throat or a tight feeling. You may struggle to inhale enough air, which can be painful or cause tension. Patients also may hear noise when they are breathing in, called stridor. This is different from a wheeze when breathing out, which is more consistent with asthma.It can also include:
Chronic throat clearing due to the constant sensation of throat irritation due to faulty nerve signals. Often confused with sinus drainage.
Neurogenic cough, which occurs as a result of nerve irritation instead of inflammation or infection
Paradoxical True Vocal Cord Movement, sometimes called exercise induced asthma, is when the vocal cords close when they should be opening. This condition can mimick asthma, and can lead to passing out.
How do we evaluate Vocal Cord Dysfunction?
The first thing we do is listen to the quality of the patient’s voice. We then perform a complete otolarygologic and airway exam with special attention to the sinuses, oral cavity, and neck to rule out other treatable causes.
A flexible laryngoscopy can then performed following placement of medicine to open up and numb the nose and throat. This allows evaluation of the vocal cords for inflammation, tumors, and movement. If any significant findings are discovered or if the cause of the voice disorder is not discovered by the initial examinations, then a flexible laryngoscopy with videostroboscopy is performed.
A flexible laryngoscopy and videostroboscopy is performed in conjunction with our Speech Pathologist, Heather Langford who has over 20 years experience with voice and swallowing analysis. The videostroboscopy portion of the procedure allows evaluation of the wave created on the vocal cord by flashing a light in sequence with the frequency of the voice. The images are then recorded for a more in depth analysis for lesions not easily seen with the naked eye. The vocal cords vibrate faster than the human retinae can see. The videostroboscopy also allows an in depth analysis of the movement of the vocal cords, such as movement found in partial paralysis or paralysis.
How do we treat Vocal Cord Dysfunction?
Vocal cord dysfunction is generally treated by identifying triggers and removing any irritants such as sinus drainage, environmental factors and intrinsic reflux or GERD. For example, managing Gastro-esophageal Reflux with medications such as antacids or proton pump inhibitors, treating sinus infections or allergies etc.
We can also use medications to calm the damaged nerves, and keep them from constantly signaling, until they are healed.
Other treatments that may be helpful include therapeutic breathing exercises that can be taught by our speech pathologist, to help you relax your throat, breathe with your abdomen and keep your vocal folds open.