Vocal cord dysfunction: what do we know?

European Respiratory Journal 37 (1), 194-200 (Jan 2011)

Kenn K, Balkissoon R 

Vocal cord dysfunction (VCD) is a disorder caused by episodic unintentional paradoxical adduction of the vocal cords, which may induce acute severe dyspnoea attacks not responsive to conventional asthma therapy. The aetiology of VCD is complex and often multifactorial. The essential pathophysiology is that of a hyperfunctional laryngeal reflex to protect the lower airway as a result of any combination of post-nasal drip, gastro-oesophageal reflux, laryngopharyngeal reflux and/or psychological conditions. Laryngoscopic demonstration of the paradoxical motion while wheezing or stridorous is considered the diagnostic gold standard. Speech therapy, including the use of special relaxed-throat breathing patterns is effective for VCD that is purely of the functional nature. Knowledge of the clinical features of VCD and identifying factors that may be contributing to the development of VCD can provide adequate clues to the correct diagnosis and management.

Laryngeal sensory testing in the assessment of patients with laryngopharyngeal reflux

The Journal of Laryngology & Otology Cambridge University Press

Copyright © JLO (1984) Limited 2009

doi:10.1017/S0022215109991587

Short Communication

O T Dale^{a1 c1}, O Alhamarneh^a1, K Young^a1 and S Mohan^a1

^a1 Derby Voice Clinic, Department of ENT Surgery, Derbyshire Royal Infirmary, Derby, UK

Abstract

Laryngopharyngeal reflux is commonly encountered in the ENT out-patient setting. It leads to impaired sensory capacity of the laryngeal mucosa. The sensory integrity of the laryngopharynx can be evaluated through endoscopic administration of pulsed air, which stimulates the laryngeal adductor reflex. The pressure of air needed to elicit this reflex indicates the degree of sensory impairment. Such laryngeal sensory testing gives a quantifiable means of assessment in patients with laryngopharyngeal reflux, and can be used to measure the response to treatment. Laryngeal sensory testing is safe and well tolerated by patients.

(Accepted June 29 2009)

Correspondence:

^c1 Address for correspondence: Mr Oliver T Dale, Department of ENT Surgery, Musgrove Park Hospital, Taunton TA1 5DA, UK. Fax: 01332347141 E-mail:otdale@doctors.net.uk