Vocal Fold Dysfunction – VCD (Paradoxical Vocal Cord Movement-PVCM)

Description. VCD is not a voice disorder per se, but sometimes voice disorders do co-occur with it. VCD involves occasional attacks of breathing difficulty, whereby the vocal folds tend to close during inhalation and/or exhalation, keeping air from normally entering or exiting the lower airway (lungs). Patients may become panicked by the difficulty breathing and are sometimes hospitalized; however, in VCD the problems is behavioral and usually can be nicely treated with breathing exercises. Sometimes, VCD co-occurs with asthma, which it not infrequently mimics. While VCD most often occurs with adults, cases have been documented with infants and children. Presentation of VCD may vary from mild dyspnea to total respiratory obstruction.

Causes. There is no known cause for VCD; however, it is commonly induced by exercise, reflux, postnasal drainage, cough and/or panic. “Triggers” for the VCD behavior may include any combination of the items listed. It may also co-occur with asthma. VCD may also be related to pharmacological agents, occupational hazards, or generalized laryngeal dysfunction.

Treatment. Behavioral therapy, usually by a speech-language pathologist in combination with medical management of physiological “triggers” (e.g., reflux, nasal drainage) and, in some cases, psychological/psychiatric support for anxiety, is effective treatment for VCD. In most cases, this comprehensive approach leads to complete resolution of the behavior in a short period of time.