eMedicine Specialties > Allergy and Immunology > Asthma

Vocal Cord Dysfunction: Treatment & Medication

Author: Praveen Buddiga, MD,, Physician, Allergy, Asthma and Immunology, Baz Allergy, Asthma and Sinus Center, Fresno, California
Contributor Information and Disclosures

Updated: Jul 10, 2009

Treatment

Medical Care

A multidisciplinary approach with a physician and speech therapist and a psychiatrist, if needed, is usually effective.6

  • Speech therapy2,7,10
    • The mainstays of treatment for vocal cord dysfunction (VCD) involve teaching the patient vocal cord relaxation techniques and breathing exercises. These procedures have been very successful and are used concomitantly with psychological support in difficult cases.
    • The role of the speech therapist is to effectively teach and communicate a comprehensive speech therapy plan with appropriate breathing exercises. When a knowledgeable speech therapist is not available, the patient can be taught a breathing relaxation exercise with the use of a simple handout.

      Relaxed throat breathing exercises.

      Relaxed throat breathing exercises.

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      Relaxed throat breathing exercises.

      Relaxed throat breathing exercises.

  • Psychotherapy2,7,13,10
    • The role of the psychiatrist is to implement cognitive behavior psychotherapy or general psychotherapy based upon evaluation of psychiatric and/or personality disorders.
    • A recent study shows psychotherapy directed towards somatoform and conversion disorders may increase efficacy when added to traditional treatment regimens.12
  • Helium-oxygen therapy10,20,21,6
    • This therapy consists of administration of a helium-oxygen mixture (heliox), which is less dense than air and thus reduces the turbulence in the airway during inspiration.
    • Heliox administration provides only a short-term benefit, but it may be very helpful in the emergent treatment of acute VCD.
  • Botulinum toxin22,23,6
    • An intralaryngeal injection of botulinum toxin relieves symptoms by blocking acetylcholine release at the motor end plate and creating a laryngeal muscle weakness, thus facilitating inspiratory and expiratory airflow.
    • Its use is considered experimental, and equivocal reports in the literature illustrate both effectiveness and lack of benefit.
  • Panting: This maneuver causes the adducted vocal cords to relax, which increases the glottic aperture.
  • Topical lidocaine24
    • This may be applied to the larynx.
    • The mechanism of action is to break the cycle of hyperactive glottal and supraglottal muscle contractions.

Consultations

  • Otolaryngologist
  • Pulmonologist
  • Allergist and/or immunologist
  • Speech therapist
  • Psychiatrist

Diet

No diet restrictions are necessary.

Medication

No specific pharmacotherapy is indicated.

More on Vocal Cord Dysfunction

Overview: Vocal Cord Dysfunction
Differential Diagnoses & Workup: Vocal Cord Dysfunction
Treatment & Medication: Vocal Cord Dysfunction
Follow-up: Vocal Cord Dysfunction
Multimedia: Vocal Cord Dysfunction
References
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References

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Further Reading

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Keywords

vocal cord dysfunction, VCD, paradoxical vocal cord motion, laryngeal dyskinesia, abnormal adduction of the vocal cords during the respiratory cycle, airflow obstruction, variable extrathoracic obstruction, inspiratory loop flattening, depression, obsessive-compulsive disorder, borderline personality disorder, neuroses induced by childhood sexual abuse, asthma

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Contributor Information and Disclosures

Author

Praveen Buddiga, MD,, Physician, Allergy, Asthma and Immunology, Baz Allergy, Asthma and Sinus Center, Fresno, California
Praveen Buddiga, MD, is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, and American Medical Association
Disclosure: Glaxo Smith Kline  Honoraria Speaking and teaching

Medical Editor

Stephen Rosenfeld, MD, Professor Emeritus, Department of Medicine, Allergy, Immunology and Rheumatology Unit, University of Rochester School of Medicine and Dentistry
Stephen Rosenfeld, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American Federation for Clinical Research, Clinical Immunology Society, and Medical Society of the State of New York
Disclosure: Elan Ownership interest None; Invitrogen Ownership interest None; Merck Ownership interest None; Pfizer Ownership interest None; Medco Health Ownership interest None; Millipore Ownership interest None

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Michael R Simon, MD, MA, Clinical Professor Emeritus, Departments of Internal Medicine and Pediatrics, Wayne State University School of Medicine; Adjunct Staff, Division of Allergy and Immunology, Department of Internal Medicine, William Beaumont Hospital
Michael R Simon, MD, MA is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, American College of Physicians, American Federation for Medical Research, Michigan Allergy and Asthma Society, Michigan State Medical Society, Royal College of Physicians and Surgeons of Canada, and Society for Experimental Biology and Medicine
Disclosure: Secretory IgA, Inc. Ownership interest Board membership

CME Editor

Timothy D Rice, MD, Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, Saint Louis University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians
Disclosure: Nothing to disclose.

Chief Editor

Michael A Kaliner, MD, Clinical Professor of Medicine, George Washington University School of Medicine; Chief, Section of Allergy and Immunology, Washington Hospital Center; Medical Director, Institute for Asthma and Allergy
Michael A Kaliner, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Clinical Investigation, American Thoracic Society, and Association of American Physicians
Disclosure: Abbott Consulting fee Consulting; Alcon Consulting fee Consulting; Glaxo Consulting fee Consulting; Greer Consulting fee Consulting; Sanofi Consulting fee Consulting; Schering Consulting fee Consulting; Teva  Consulting; Meda Honoraria Speaking and teaching

 
 
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