Speech Therapy for Vocal Cord Dysfunction (VCD)
Vocal cord dysfunction (VCD) is a condition that can lead to breathing difficulties. The symptoms of VCD are often confused with asthma; however, there is a distinction between the two conditions. Vocal cord dysfunction is a disorder of the vocal cords that results in difficulty breathing, whereas asthma is a respiratory condition marked by spasms in the bronchi of the lungs.
The primary symptom of VCD is shortness of breath. Still, other symptoms may include wheezing, coughing, and a feeling of tightness in the throat. VCD can be triggered by many things, including exercise, emotions, weather changes, or even just speaking. Many people with VCD find that their symptoms are worse when they are under stress.
While there is no cure for VCD, there are treatments that can help manage the symptoms and make it easier to live with the condition. One of the most effective treatments for VCD is speech therapy.
Speech therapy can help to retrain the muscles around the vocal cords and help the person learn how to control them, reducing symptoms and improving quality of life.
If you think you or someone you know may have VCD, it is important to see a doctor for a proper diagnosis. Once diagnosed, speech therapy can be used as an effective treatment for this condition and make a difference in the lives of those affected by VCD.
In this article, you will learn about the following:
What is Vocal Cord Dysfunction (VCD)?
What Causes Vocal Cord Dysfunction?
What are the Symptoms of Vocal Cord Dysfunction?
How is Vocal Cord Dysfunction Diagnosed?
How Can You Prevent VCD Episodes?
What is Vocal Cord Dysfunction (VCD)?
VCD is also called paradoxical vocal fold motion (PVFM), paradoxical vocal cord motion, or paradoxical vocal fold movement.
The term "paradoxical" is used because the vocal cords close when they should open during inhalation.
The vocal cords are two bands of smooth muscle tissue in the larynx (voice box). During normal breathing, your vocal cords open widely when you breathe in (inhale). Your vocal cords close when you speak, sing, swallow, or lift heavy items. A VCD episode can occur when the vocal folds do not open and close smoothly. Symptoms may include shortness of breath, a feeling of chest tightness, and wheezing.
VCD can occur at any age, but it is most common in children and young adults and is seen more often in women than men.
What Causes Vocal Cord Dysfunction?
The exact cause of VCD is unknown. People who suffer from VCD can have highly sensitive airways. Common triggers for VCD may include:
Allergies
Anxiety
Respiratory infections
Post-nasal drip
GERD (gastroesophageal reflux disease)
Exercise
Pollution or other irritants in the air
Cigarette smoke
Chemical fumes
What are the Symptoms of Vocal Cord Dysfunction?
Vocal cord dysfunction symptoms can vary from person to person. The primary symptom of VCD is shortness of breath. Other symptoms of paradoxical vocal cord movement may include:
Trouble speaking
Throat clearing
Wheezing
Throat tightness
Difficulty swallowing
How is Vocal Cord Dysfunction Diagnosed?
Difficulties in diagnosing VCD may arise because the condition mirrors asthma symptoms so closely. Many patients are initially misdiagnosed with exercise-induced asthma (EIA) when they have VCD. Your doctor may perform a variety of tests to rule out other potential issues and make a VCD diagnosis, which may include:
A flow-volume loop
A flow-volume loop test shows how air flows into the lungs and identifies any blockage. Usually, the expiratory loop (breathing out) will appear normal in a VCD patient, while the inspiratory loop (breathing in) appears flat. A flow-volume loop may be performed while you're at rest or when you're exercising.
Laryngoscopy
Laryngoscopy is a diagnostic procedure during which a thin, flexible tube with a tiny camera (endoscope) is inserted through the nose or mouth to visualize the voice box and the vocal cords. Laryngoscopy can be performed in a hospital setting by an ENT (ear, nose, and throat specialist) or in the office of a specially trained speech-language pathologist.
Stroboscopy
This diagnostic procedure uses a strobe light just above the vocal cords to slow their movement. Stroboscopy allows the ENT to see any abnormalities in cord vibration and closure.
Exercise Challenge Test (ECT)
The ECT is an in-office test used to diagnose VCD. The patient is asked to do a series of vocal and breathing exercises while monitored with a spirometer, measuring airflow. The test is positive if the patient experiences symptoms of VCD (wheezing, coughing, etc.) during or immediately after the exercise.
How Can You Prevent VCD Episodes?
There is no sure way to prevent vocal cord dysfunction episodes, but there are some things you can do to reduce your risk:
Avoid triggers
An allergy, cold or viral infection, and upper respiratory infection can trigger a VCD episode. Avoiding these triggers can help prevent symptoms.
Manage stress
Stress and anxiety can trigger vocal cord dysfunction episodes. Managing stress can help reduce your risk of vocal cord dysfunction episodes.
Don't smoke
Smoking irritates the vocal cords and can make VCD symptoms worse. Quitting smoking can help reduce your risk of vocal cord dysfunction episodes.
Drink plenty of fluids
Staying hydrated helps keep the mucus in your respiratory system thin, making it less likely to trigger an episode of vocal cord dysfunction.
Get regular exercise
Exercise can help with difficulty breathing and reduce stress. Regular exercise may help prevent vocal cord dysfunction episodes.
Make dietary changes
Certain foods and drinks can trigger vocal cord dysfunction symptoms. You may need to avoid acidic foods like citrus fruits, tomatoes, and coffee. You may also need to avoid dairy products like milk and cheese.
What Can You Expect From Vocal Cord Dysfunction Treatment?
The primary treatment for VCD is speech therapy. Speech therapy for VCD can help you control and coordinate the movement of the vocal cords so that you can speak and breathe normally.
A speech-language pathologist (SLP) with specialized training in working with VCD is the ideal person to help. The goal of VCD treatment is to coordinate the movement of your vocal cords and improve your breathing pattern.
Breathing exercises for VCD may involve practicing deep, pursed-lip, and diaphragmatic breathing. The goal of breathing exercises is to help you control your breathing to prevent VCD episodes from occurring. Your SLP will also teach you how to use these techniques to help take you out of a VCD episode.
You will also learn stretching and relaxation techniques to reduce muscle tension and improve vocal fold movement. Relaxation exercises may involve progressive muscle relaxation, visualization, and deep breathing.
VCD speech therapy may require multiple sessions, and the therapist will work with you to determine the best course of treatment.
Anxiety and stress can trigger VCD episodes. Meeting with a professional specializing in anxiety disorders can help you learn how to manage your anxiety and cope with stress.
Sometimes, your doctor may prescribe medications to treat underlying conditions that may trigger vocal cord dysfunction, such as acid reflux or allergies.
How Long Does it Take to Cure Vocal Cord Dysfunction?
If you have vocal cord dysfunction, you must see a doctor or speech therapist who can help you manage your symptoms. Vocal cord dysfunction is a condition that can be managed with treatment, but it is not always curable.
The length of time it takes to see improvement from vocal cord dysfunction speech therapy may vary from person to person, but generally, people see improvement after 3-4 weeks of therapy. With proper treatment, you can live a normal, healthy life.
Why Choose Connected Speech Pathology for VCD Therapy?
At Connected Speech Pathology, we understand how frustrating and debilitating vocal cord dysfunction can be. We are dedicated to helping our patients find relief from their symptoms and improve their quality of life.
We offer VCD therapy services to children and adults. Our speech pathologists are specially trained in diagnosing and treating vocal cord dysfunction. We create personalized treatment plans to meet our patient's unique needs.
We offer different ways to help you manage your vocal cord dysfunction, including:
Breathing exercises
Stretching and relaxation techniques
Basic anxiety management & dietary counseling
If you are struggling with vocal cord dysfunction, we can help. Contact us today to schedule an appointment.
About the Author
Allison Geller is a speech-language pathologist (SLP) and the owner of Connected Speech Pathology. She obtained her Bachelor’s and Master’s degrees from the University of Florida in Speech-Language Pathology. Allison has practiced speech therapy in a number of settings including telepractice, acute care, outpatient rehabilitation, and private practice. She has worked extensively with individuals across the lifespan including toddlers, preschoolers, school-aged children, and adults. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including receptive/expressive language disorders, articulation disorders, voice disorders, fluency disorders, brain injury, and swallowing disorders.
Allison served as the clinical coordinator of research in aphasia in the Neurological Institute at Columbia University Medical Center in New York. She is on the Board of Directors for the Corporate Speech Pathology Network (CORSPAN), a Lee Silverman Voice Treatment (LSVT) certified clinician, and a proud Family Empowerment Scholarship/Step-Up For Students provider. Allison is passionate about delivering high quality-effective treatment remotely because it’s convenient and easy to access. What sets us apart from other online speech therapy options is—Allison takes great care to hire the very best SLPs from all over the country.
