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Vocal Cord Dysfunction

Paradoxical Vocal Fold Motion (PVFM)

Vocal Cord Dysfunction (VCD)


A number of clinical syndromes can mimic asthma and lead to inaccurate diagnosis and inappropriate, potentially harmful treatment.

Patients diagnosed with severe, uncontrollable asthma may actually have Paradoxical Vocal Fold Motion (PVFM)/Vocal Cord Dysfunction (VCD).  Most patients carry a diagnosis of asthma unresponsive to therapy.  PVFM can occur along with asthma.

Patients will present with or describe the following symptoms:

1.   Stridor or noisy breathing when breathing in

2.   Wheezing

3.   Difficulty swallowing

4.   Shortness of breath

5.   Hoarseness

6.   Tightness in throat or upper chest

In adults, these attacks may often be precipitated by irritants or may be related to stress.  There is also a relationship to reflux as a trigger. With children and adolescents, there is a strong link to participation in competitive sports activities and the attacks may also be related to stress.

What is happening during a VCD attack?
The front 2/3 of the vocal folds are closing while the patient is trying to breathe in through a narrow opening at the back of the vocal folds.

What will be done in therapy?
The speech-language pathologist will use techniques adapted from treatment of functional voice disorders to teach the patient how to gain control of breathing and the opening and closing of vocal cords.  In addition, if the problem is related to stress, some short term psychological intervention may be helpful for relaxation techniques.