Vocal Cord Dysfunction Differential Diagnoses

Updated: Sep 18, 2023
  • Author: Praveen Buddiga, MD, FAAAAI; Chief Editor: Michael A Kaliner, MD  more...
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Diagnostic Considerations

Laryngomalacia, vocal cord paresis, and CNS causes must be differentiated from vocal cord dysfunction (VCD). [27] Additionally, VCD is often misdiagnosed as asthma.

Antenatal prolapse must also be considered. [28]

Table 1. Differential diagnosis of laryngeal movement disorders [29, 30, 31] (Open Table in a new window)



Somatoform disorder, conversion disorder, abuse, anxiety disorder, depression, Munchausen syndrome, malingering
Exercise Exercise

Extrinsic (chemical irritants, olfactory stimuli)

Intrinsic (GERD, laryngopharyngeal reflux rhinits/post nasal drip, sinusitis)

Laryngospasm Intubation, airway manipulation, IgE mediated, nocturnal aspiration
Vocal Cord Paresis/Paralysis Prolonged intubation, recurrent laryngeal or vagus nerve damage during chest or thyroid surgery, idiopathic
Infectious Epiglottis, bronchiolitis, laryngotracheobronchitis (croup), laryngitis, pharyngeal abscess, diphtheria, pertussis, laryngeal papillomatosis
Neoplastic Head and neck malignancy, cystic hygroma, hemangioma, rhabdomyosarcoma, teratoma, lymphoma, papilloma
Endocrine Thyroid goiter


Differential Diagnoses