Korean J Med.  2004 Nov;67(Suppl 3):S902-S907.

Two cases of vocal cord dysfunction

• Koh YI
• Choi IS
• Chung SU

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.

Keyword

Vocal cords; Asthma

MeSH Terms

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*
Adrenal Cortex Hormones