Problemi speciali
“Vocal cord dysfunction”: quando l’asma non convince
VOCAL CORD DYSFUNCTION
S. Dal Bo, R. Meneghetti, G. Longo
UO Semplice di Allergologia e Trattamento dell’Asma, IRCCS “Burlo Garofolo”, Trieste
Settembre 2008 - pagg. 445 -450
Abstract
The vocal cord dysfunction syndrome is a disease characterized by short crisis of dyspnea
due to a paradoxical movement in adduction of vocal cords, with consequent laringeal
narrowing, mainly inspiratory dyspnea/apnea and choking feeling. This manifestation
is often interpreted and treated as asthma, also because, usually, these crisis follow
physical exercise. The diagnosis is essentially based on the careful collection of the clinical
history elements characterizing the dyspnoic crisis and excluding alternative diagnosis
(negative physical examination and negative instrumental diagnostical check). This
kind of dysfunction is considered as a conversion disease and no pharmacological treatment
is available. When just the communication to patients and parents that this illness is
harmless and not dangerous is not sufficient to solve the problem, speech therapy and
breath re-education are used.
Parole chiave
Bibliografia
1. Noyes BE, Kemp JS. Vocal cord dysfunction
in children. Ped Resp Rev 2007;8:155-63.
2. Newman KB, Mason UG, Schmaling KB. Clinical features of vocal cord dysfunction. Am J Resp Crit CareMed 1995;152:1382-6.
3. O’Connel MA, Sklarew PR, Goodman DL. Spectrumof presentation of paradoxical vocal cord motion in ambulatory patients. Ann Allergy Asthma Immunol 1995;74:341-4.
4. Kayani S, Shannon D. Vocal cord dysfunction associated with exercise in adolescent girls. Chest 1998;113:540-2.
5. Perkner JJ, Fennelly KP, Balkissoon R, et al. Irritant-associated vocal cord dysfunction. J Occup EnvironMed 1998;40:136-43.
6. Brugman SM. Themany faces of vocal cord dysfunction: what 36 years of literature tell us. Am J Respir Crit CareMed 2003;167:A588.
7. Dunglison RD. The practice of medicine. Philadelphia: Lea & Blanchard,1842; 247-58.
8. MacKenzie M. Use of the laryngoscopy in disease of the throat. Philadelphia: Lindsey & Blakeston, 1869:246-50.
9. Christopher KL, Wood RP, Eckert RC, Blager FB, Raney RA, Souhrada JF. Vocal cord dysfunction presenting as asthma. N Engl JMed 1983;308:1556-70.
10. Rogers JH. Functional inspiratory stridor in children. J Laringol Otol 1980;96:669-70.
11. Powell DM, Karanfilov BI, Beechler KB, Areole K, Trudeau MD, Forrest A. Paradoxical vocal cord dysfunction in juveniles. Arch Otolaryngol Head Neck Surg 2000;126:29-34.
12. Ayers JG, Gabbot PLA. Vocal cord dysfunction and laryngeal hyperesponsiveness: a function of altered autonomic balance? Thorax 2002;57:284-5.
13. Koufman JA, Wiener GJ, Castell DO. Reflex laryngitis and its sequelae: the diagnostic role of ambulatory 24-hour pH monitor. J Voice 1988;2:78-89.
14. Selner JC, staudenmayer H, Koepke JW, Harvey R, Christopher K. Vocal cord dysfunction: the importance of psychologic factors and provocation challenge testing. J Allergy Clin Immunol 1987;79:729-33.
15. Ramirez J, Leon I, Rivera LM. Episodic laryngeal dyskinesia-clinical and psychiatric characterization. Chest 1986;90:716-21.
16. FreedmanMR, Rosemberg SJ, Schmaling KB. Childhood sexual abuse in patients with paradoxical vocal cord dysfunction. J Nerv Ment Dis 1991;179:295-8.
17. Seifert E, Kollbrunner F. Vocal cord dysfunction: dealing with aggressivity. Swiss MedWKLY 2007;137:127-9.
18. Rundell KW, Spiering BA. Inspiratory stridor in elite athletes. Chest 2003;123:468-74.
19. Landwehr LP, Wood RP, Milgrom H. Vocal cord dysfunctionmimicking exercise-induced bronchospasm in adolescents. Chest 1996;98: 971-4.
20. McFadden ER, Zawadski DK. Vocal cord dysfunction masquerading an exercise-induced asthma. A physiologic cause for “Choking” during athletic activities. Am J Respir Crit CareMed 1996;153:942-7.
21. Soli CG, Smally AJ. Vocal cord dysfunction: an uncommon cause of stridor. J Emergency Med 2005;28:31-3.
22. Kellman RM, Leopold DA. Paradoxical vocal cordmotion: an important cause of stridor. Laryngoscope 1982;92:58-60.
23. Denoyelle F, Garabedian EN, Roger G, Tashjian G. Laryngeal dyskinesia as a cause of stridor in infants. Arch Otolaryngol Head Neck Surg 1996;122:612-6.
24. Park DP, Ayres JG, McLeod DT, Mansur AH. Vocal cord dysfunction treated with longterm tracheostomy: 2 case studies. Ann Allergy Asthma Immunol 2007;98:591-4.
25. Vlahakis NE, Patel AM, Maragos NE, Beck KC. Diagnosis of vocal cord dysfunction. The utility of spirometry and plethysmography. Chest 2002;122:2246-9.
26. Rosenthal M. Differential diagnosis of asthma. Pediatric Respire Reviews 2002;3: 148-53.
27. Davis R., Brugman S, Larsen G. Use of videography in the diagnosis of exercise induced vocal cord dysfunction: a case report with video clips. J Allergy Clin Immunol 2007:1329- 31.
28. Weinberger M, Abu-Hasan M. Pseudoasthma: when cough, wheezing, and dyspnea are not asthma. Pediatrics 2007;120:855-64.
29. Tajchman UVV, Gitterman B,WeinbergM. Exercise-induced dyspnea in children and adolescents: if not asthma then what? Ann Allergy Asthma Immunol 2005;94:366-71.
30. Weir M. Vocal cord dysfunction mimics asthma and may respond to heliox. Clin Pediatr 2002;41:403-7.
31. Archer GJ, Hoyle JL, McCluskey A. Inspiratory vocal cord dysfunction: a new approach in treatment. Eur Respir J 2000;15:617-8.
32. Morris MF, Allan PF, Perkins PJ. Vocal cord dysfunction. etiologies and treatment. Clin PulmMed 2006;13:73-86.
33. Doshi DR, Weinberger MM. Long-term outcome of vocal cord dysfunction. Ann Allergy Asthma Immunol 2006;96:794-9.
34. Powell C, Brazier A. Psychological approaches to the management of respiratory symptoms in children and adolescents. Ped Resp Rev 2004;5:214-24.
35. Sullivan MD, Heywood BM, Beukelman DR. A treatment for vocal cord dysfunction in female athletes: an outcome study. Laryngoscope 2001;111(10):1751-5.
36. Kuppersmith R, Rosen DS, Wiatrak BJ. Functional stridor in adolescents. J Adolesc Health 1993;14:166-71.
2. Newman KB, Mason UG, Schmaling KB. Clinical features of vocal cord dysfunction. Am J Resp Crit CareMed 1995;152:1382-6.
3. O’Connel MA, Sklarew PR, Goodman DL. Spectrumof presentation of paradoxical vocal cord motion in ambulatory patients. Ann Allergy Asthma Immunol 1995;74:341-4.
4. Kayani S, Shannon D. Vocal cord dysfunction associated with exercise in adolescent girls. Chest 1998;113:540-2.
5. Perkner JJ, Fennelly KP, Balkissoon R, et al. Irritant-associated vocal cord dysfunction. J Occup EnvironMed 1998;40:136-43.
6. Brugman SM. Themany faces of vocal cord dysfunction: what 36 years of literature tell us. Am J Respir Crit CareMed 2003;167:A588.
7. Dunglison RD. The practice of medicine. Philadelphia: Lea & Blanchard,1842; 247-58.
8. MacKenzie M. Use of the laryngoscopy in disease of the throat. Philadelphia: Lindsey & Blakeston, 1869:246-50.
9. Christopher KL, Wood RP, Eckert RC, Blager FB, Raney RA, Souhrada JF. Vocal cord dysfunction presenting as asthma. N Engl JMed 1983;308:1556-70.
10. Rogers JH. Functional inspiratory stridor in children. J Laringol Otol 1980;96:669-70.
11. Powell DM, Karanfilov BI, Beechler KB, Areole K, Trudeau MD, Forrest A. Paradoxical vocal cord dysfunction in juveniles. Arch Otolaryngol Head Neck Surg 2000;126:29-34.
12. Ayers JG, Gabbot PLA. Vocal cord dysfunction and laryngeal hyperesponsiveness: a function of altered autonomic balance? Thorax 2002;57:284-5.
13. Koufman JA, Wiener GJ, Castell DO. Reflex laryngitis and its sequelae: the diagnostic role of ambulatory 24-hour pH monitor. J Voice 1988;2:78-89.
14. Selner JC, staudenmayer H, Koepke JW, Harvey R, Christopher K. Vocal cord dysfunction: the importance of psychologic factors and provocation challenge testing. J Allergy Clin Immunol 1987;79:729-33.
15. Ramirez J, Leon I, Rivera LM. Episodic laryngeal dyskinesia-clinical and psychiatric characterization. Chest 1986;90:716-21.
16. FreedmanMR, Rosemberg SJ, Schmaling KB. Childhood sexual abuse in patients with paradoxical vocal cord dysfunction. J Nerv Ment Dis 1991;179:295-8.
17. Seifert E, Kollbrunner F. Vocal cord dysfunction: dealing with aggressivity. Swiss MedWKLY 2007;137:127-9.
18. Rundell KW, Spiering BA. Inspiratory stridor in elite athletes. Chest 2003;123:468-74.
19. Landwehr LP, Wood RP, Milgrom H. Vocal cord dysfunctionmimicking exercise-induced bronchospasm in adolescents. Chest 1996;98: 971-4.
20. McFadden ER, Zawadski DK. Vocal cord dysfunction masquerading an exercise-induced asthma. A physiologic cause for “Choking” during athletic activities. Am J Respir Crit CareMed 1996;153:942-7.
21. Soli CG, Smally AJ. Vocal cord dysfunction: an uncommon cause of stridor. J Emergency Med 2005;28:31-3.
22. Kellman RM, Leopold DA. Paradoxical vocal cordmotion: an important cause of stridor. Laryngoscope 1982;92:58-60.
23. Denoyelle F, Garabedian EN, Roger G, Tashjian G. Laryngeal dyskinesia as a cause of stridor in infants. Arch Otolaryngol Head Neck Surg 1996;122:612-6.
24. Park DP, Ayres JG, McLeod DT, Mansur AH. Vocal cord dysfunction treated with longterm tracheostomy: 2 case studies. Ann Allergy Asthma Immunol 2007;98:591-4.
25. Vlahakis NE, Patel AM, Maragos NE, Beck KC. Diagnosis of vocal cord dysfunction. The utility of spirometry and plethysmography. Chest 2002;122:2246-9.
26. Rosenthal M. Differential diagnosis of asthma. Pediatric Respire Reviews 2002;3: 148-53.
27. Davis R., Brugman S, Larsen G. Use of videography in the diagnosis of exercise induced vocal cord dysfunction: a case report with video clips. J Allergy Clin Immunol 2007:1329- 31.
28. Weinberger M, Abu-Hasan M. Pseudoasthma: when cough, wheezing, and dyspnea are not asthma. Pediatrics 2007;120:855-64.
29. Tajchman UVV, Gitterman B,WeinbergM. Exercise-induced dyspnea in children and adolescents: if not asthma then what? Ann Allergy Asthma Immunol 2005;94:366-71.
30. Weir M. Vocal cord dysfunction mimics asthma and may respond to heliox. Clin Pediatr 2002;41:403-7.
31. Archer GJ, Hoyle JL, McCluskey A. Inspiratory vocal cord dysfunction: a new approach in treatment. Eur Respir J 2000;15:617-8.
32. Morris MF, Allan PF, Perkins PJ. Vocal cord dysfunction. etiologies and treatment. Clin PulmMed 2006;13:73-86.
33. Doshi DR, Weinberger MM. Long-term outcome of vocal cord dysfunction. Ann Allergy Asthma Immunol 2006;96:794-9.
34. Powell C, Brazier A. Psychological approaches to the management of respiratory symptoms in children and adolescents. Ped Resp Rev 2004;5:214-24.
35. Sullivan MD, Heywood BM, Beukelman DR. A treatment for vocal cord dysfunction in female athletes: an outcome study. Laryngoscope 2001;111(10):1751-5.
36. Kuppersmith R, Rosen DS, Wiatrak BJ. Functional stridor in adolescents. J Adolesc Health 1993;14:166-71.
Corrispondenza: longog@burlo.trieste.it