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Vocal cord dysfunction (VCD) is a condition affecting the vocal cords. [1] It is characterized by abnormal closure of the vocal folds, which can result in significant difficulties and distress during breathing, particularly during inhalation. [1] Due to the similarity in symptoms, VCD attacks are often mistaken for asthma attacks or laryngospasms.
Acute cases usually occur as part of a viral upper respiratory tract infection, [1] other infections, and trauma such as from coughing or other causes. [1] Chronic cases may occur due to smoking, tuberculosis, allergies, acid reflux, rheumatoid arthritis, or sarcoidosis. [1] [3] The underlying mechanism involves irritation of the vocal cords. [2]
Laryngospasm is an uncontrolled or involuntary muscular contraction of the vocal folds. [1] It may be triggered when the vocal cords or the area of the trachea below the vocal folds detects the entry of water, mucus, blood, or other substance.
Vocal fold lesions such as a vocal fold nodule or other changes in the vocal fold mucosa can lead to increased tension in the larynx and cause dysphonia. [2] Larynogopharyngeal reflux, a process that is similar to GERD, can bring stomach acid into the larynx. This can provoke the larynx to tense to prevent the aspiration of the acid. [3]
Symptoms of spasmodic dysphonia can come on suddenly or gradually appear over the span of years. They can come and go for hours or even weeks at a time, or remain consistent. Gradual onset can begin with the manifestation of a hoarse voice quality, which may later transform into a voice quality described as strained with breaks in phonation. [6]
Post-infection coughs can span months, depending on the virus strain, but seeking medical care at the eight-week mark is crucial to identify other causes. The three main chronic cough causes are ...
Laryngopharyngeal reflux (LPR) or laryngopharyngeal reflux disease (LPRD) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. [4] [5] LPR causes respiratory symptoms such as cough and wheezing [6] and is often associated with head and neck complaints such as dysphonia, globus pharyngis, and dysphagia. [7]
Laryngotracheal stenosis is an umbrella term for a wide and heterogeneous group of very rare conditions. The population incidence of adult post-intubation laryngotracheal stenosis which is the commonest benign sub-type of this condition is approximately 1 in 200,000 adults per year. [10] The main causes of adult laryngotracheal stenosis are: