Vocal Cord Dysfunction

The vocal cords are muscles within the larynx, also called the voice box. When we breathe, they open & close involuntarily, meaning no direct action is required from the person to actively make them open or close. When talking, we choose the sounds to make, but the vocal cords respond with little active thought from us. These structures are located at the top of your breathing tube known as your trachea.

As we breathe, air passes through the vocal cords on its way to the trachea and downward to the lungs. The process is reversed as we exhale. The cords should be relaxed and open as we breathe in. If the cords tighten when we breathe in, the person may report difficulty breathing ranging from mild shortness of breathe to severe spasms of choking and inability to breathe. This out of sequence closing is known as Vocal Cord Dysfunction or VCD. Other names for this condition are Irritable Laryngeal Syndrome or Laryngospasm.

Symptoms of VCD may be:

  • Cough
  • Anxiousness
  • Dizziness
  • Frequent clearing of the throat
  • Hoarseness
  • Choking
  • Sighing
  • Sensation of not being able to get a breath
  • Tightness of the upper chest or throat
  • Noisy breathing, stridor, whistling of the air when breathing in

Some of the triggers for VCD are the same as the triggers for asthma, some are different.

  • Exercise
  • Post Nasal Drip
  • Psychosocial issues
  • Stress / Anxiety
  • Cough from irritants or viral illness
  • Activities of voice strain – singing, excessive talking, yelling

VCD is three times more common in females than males. It can mimic or look like asthma to someone unfamiliar with the condition. In some people, VCD can trigger their asthma. Some people with VCD do not have asthma. Asthma symptoms usually increase over a few hours, days, or weeks and respond to medications that open the airway and reduce the inflammation. VCD symptoms usually occur or decrease suddenly and do not respond well to traditional asthma treatments. The moisture and patterned breathing associated with the SVN machine may help VCD. Often the person with VCD will experience voice changes, like hoarseness, and prolonged coughing episodes.

The best treatment for VCD is speech therapy with specific voice & breathing exercises. It is important to rest the voice, drink fluids, encourage salivation with lozenges or gum, reduce exposure to triggers when possible, and reduce stress. Keep a list of what you are doing when the VCD occurs. Listed below are two exercises that our clinic teaches to help patients relax the vocal cords.

PAUSED BREATHING:

  1. Sit in a position that allows your neck & shoulders to relax but keep your back straight.
  2. Breathe in gently through the nose.
  3. Stick your tongue out of your mouth, past the teeth & lower lip, in preparation to exhale. This forward stretch of the tongue helps to open the airway at the vocal cords. This may be difficult to do with a severe spasm but will be easier the more you repeat this exercise.
  4. With the tongue out, exhale only through the mouth in slow, paused or spaced breaths. The timing should be like saying Ha, Ha, Ha, Ha, very slowly. Don’t use your voice, just breathe out.
  5. Repeat 10 times and practice 3 times a day so you will know how to do it well when VCD occurs.

BELLY BREATHING:

  1. Sit in a position that allows your neck and shoulders to relax but keep your back straight.
  2. Place your hand on your belly. Breathe in gently through the nose with your belly pushing your hand outward from your body.
  3. As you start to exhale, place the tip of your tongue where your upper teeth meet the roof of your mouth. This will allow you to make a hissing or “S” sound as you exhale. This creates a back pressure to help keep the airway open.
  4. Slowly exhale allowing the hand & belly to move inward to a resting position and make the hissing or “S” sound as you push the air between your tongue & teeth.
  5. Repeat 10 times & practice 3 times a day so you will know how to do it well when VCD occurs.