Vocal cord dysfunction (VCD) is a condition in which the vocal cords stop functioning normally and cut off the person's air supply. This restricts breathing and can cause a persistent cough, chest tightness, and shortness of breath. Doctors diagnose VCD using breathing tests and examining the throat with a laryngoscope. Treatment typically includes vocal cord therapy with a speech therapist or psychologist.
On this page:
What Is Vocal Cord Dysfunction?
Vocal cord dysfunction (VCD) is a condition in which the vocal cords spontaneously close, cutting off the air supply. It can often present like asthma, and some individuals may experience symptoms of both conditions simultaneously.
The vocal cords are located in the larynx of your throat, also called the voice box. These cords open as you inhale and exhale to allow for breathing and speaking. When the vocal cords stop functioning correctly, they can close up without warning, restricting breathing and airflow.
What is the difference between vocal cord dysfunction and asthma?
VCD can often be mistaken for exercise-induced asthma, but there are subtle differences in the symptoms of the two diseases. It’s important to note that some people may have both asthma and VCD, and their symptoms may be hard to tell apart.
VCD distinctions
- Albuterol inhaler doesn’t control symptoms.
- Difficulty inhaling.
- Hoarseness.
- Recovery time is less than 10 minutes.
- Symptoms occur shortly after beginning exercise.
- Symptoms recur immediately when exercise is resumed after Albuterol treatment.
- Tightness in the throat.
Exercise-induced asthma distinctions
- Albuterol inhaler controls symptoms.
- Difficulty exhaling.
- No hoarseness.
- Recovery takes up to an hour without medication.
- Symptoms are less severe when exercise is resumed after Albuterol treatment.
- Symptoms occur later in exercise.
- Tightness in the middle or lower chest.
How common is vocal cord dysfunction?
Experts aren’t quite sure just how common VCD is because it is often misdiagnosed as asthma — as many as 30% of asthma cases could be VCD!
What causes vocal cord dysfunction?
VCD is always caused by a physical or mental trigger in the body, but the reasons for the trigger vary.
The most common causes of VCD are:
- Breathing in toxins, irritants, pollution, or other strong odors.
- Depression, anxiety, stress, or other strong emotions.
- Exercise or intense physical exertion.
- Gastroesophageal reflux disease (GERD) — The backward flow of acid into the stomach.
- Laryngopharyngeal reflux disease (LPRD) — The backward flow of acid into the larynx.
- Post-nasal drip.
Vocal cord dysfunction risk factors
You are more likely to develop VCD if you:
- Are between the ages of 20 and 40.
- Are female.
- Have suffered a traumatic injury to the airways.
- Play a wind instrument.
- Play competitive sports.
- Suffer from chronic respiratory illnesses or sinus infections.
- Struggle with mental health complications or emotional trauma.
Complications of vocal cord dysfunction
VCD can cause complications such as:
- Collapsed lung.
- Laryngospasms — Uncontrolled muscle spasms of the vocal folds.
- Obstructed airways.
What Are the Signs and Symptoms of Vocal Cord Dysfunction?
Symptoms of VCD include:
- A choking or suffocating feeling when trying to breathe.
- Chronic coughing or throat clearing.
- Intermittent hoarseness.
- Shortness of breath.
- Upper chest or throat tightness.
- Wheezing or stridor (high-pitched sound) when breathing.
Individuals may experience symptoms of VCD during exercise and while laughing or crying.
When should I see a doctor about my vocal cord dysfunction symptoms?
If you are experiencing any of the above symptoms, schedule a visit with your primary care provider to receive a proper diagnosis.
How Do You Diagnose Vocal Cord Dysfunction?
First, your doctor will ask you about your symptoms and health history. They will perform a physical examination to rule out asthma, vocal cord damage, and other vocal cord complications that may be causing your symptoms.
Next, expect your doctor to run some tests to diagnose VCD. Since VCD can be tricky to diagnose formally, multiple tests may be ordered to get a full picture of your condition.
Tests to diagnose vocal cord dysfunction include:
- Laryngoscopy – The most common and accurate test for diagnosing VCD. During this procedure, a laryngoscope (a small tube with a camera on the end) is put in through the nose to the back of the throat to examine the vocal folds.
- Spirometry – This breathing test determines your lung function by calculating the amount and speed of breath that can be inhaled and exhaled. The test involves inhaling and exhaling into a tube through your mouth while wearing a clip on your nose.
How Do You Treat Vocal Cord Dysfunction?
Treatment options for VCD may include medication, therapy, or both, depending on the trigger.
Medication to treat vocal cord dysfunction
If your VCD is triggered by acid-related conditions, such as LPRD or GERD, antireflux medication may help reduce irritation and symptoms. Your doctor may also recommend dietary changes that can help reduce reflux.
If your trigger is post-nasal drip or another respiratory illness, a prescribed nasal spray or wash may help alleviate your symptoms.
Mental health therapy to treat vocal cord dysfunction
Anxiety, depression, stress, and other strong emotions can be triggers for VCD. Working with a mental health therapist or counselor can help alleviate symptoms through relaxation exercises, talk therapy, and biofeedback.
Speech therapy to treat vocal cord dysfunction
Working with a speech therapist or psychologist to learn vocal fold control techniques is a common treatment for VCD. These techniques can help relax the throat muscles to avoid uncontrollable spasms. They require practice several times a day, even when symptoms are not active, so the muscles can learn how to behave properly when an episode begins.
Other therapies can include breathing therapy, especially for athletes with exercise-induced asthma-like symptoms.
