Vocal cord dysfunction

Final easier to breathe

Vocal cord dysfunction (VCD), an often misunderstood vocal cord disorder, leads to symptoms that are similar to those of bronchial asthma or can occur together with asthma. For this reason, this disease is often misinterpreted as asthma and therefore not treated properly or completely. Similar to bronchial asthma, the symptoms in VCD occur very suddenly. They are sometimes so intense that they are experienced as life-threatening, but typically stop relatively quickly.

Our experienced consultants at Schoen Clinic have specialised in treating vocal cord dysfunction for over twenty years. They have given countless lectures on this subject at specialist conferences and published scientific articles. National and international scientific studies on the clinical picture are also underway. Allocation takes place using concepts that were agreed upon with the cost bearers. With effective therapies, we help you to regain a better quality of life.

Causes & symptoms

Causes: How vocal cord dysfunction develops

Even if the causes have not yet been clarified in full, it is very clear that purely physical problems, in particular, can trigger VCD. 

These include:  
  • Reflux symptoms (e.g. ‘acid regurgitation’)
    The typical heartburn felt above the stomach plays a lesser role than the reflux that occurs in the throat. Even the smallest amounts of acid or gastric fluid are sufficient to cause the vocal cords to close.
  • Flow of secretion from the nose and paranasal sinuses
    Inflammatory secretion flows down the pharyngeal wall in the direction of the vocal cords and therefore also irritates the vocal cords.

Both for reflux and for secretions from the nasal area, the closure of the vocal cords initially represents a very important, natural defensive reflex. The vocal cord region is the last part of the body where harmful fluids can be stopped from entering the lungs.
Today, experts assume that this important reflex becomes vocal cord dysfunction via special mechanisms that are as yet not explained. 

Psychological causes of vocal cord dysfunction?

A psychosomatic cause was primarily suspected in the first publications around 15 to 20 years ago. Discussions focused on particular personality structures, as well as on increased anxiety and panic intensity. Sexual, physical or psychological stress situations are also mentioned frequently.

Vocal cord dysfunction: Symptoms of the disorder

Typical vocal cord dysfunction symptoms are problems with very sudden shortness of breath. These can develop from one breath to the next. It is often a cough fit that triggers this shortness of breath. The intensity can differ widely: Some patients only experience a feeling of restricted breathing, while others are afraid of suffocating immediately. Vocal cord dysfunction is thus often experienced as a very threatening disease. VCD mainly affects women.

Around two thirds of VCD patients also have bronchial asthma, meaning that asthma symptoms can occur in addition to the VCD problem. 


Diagnosis: How we diagnose vocal cord dysfunction

When asked questions, most patients can say that their inhalation is restricted and they experience the problem in the upper respiratory tract or throat. This description alone clearly suggests the suspicion of vocal cord dysfunction (VCD). In the consultation, our specialists also ask what triggers the attacks of shortness of breath and what role the cough plays in them.

Vocal cord endoscopy for an accurate diagnosis

The precise diagnosis can be made unambiguously in many cases by means of an endoscopy of the vocal cords with a simultaneous lung function measurement. As part of this, you will be confronted with your problem stimuli during the laryngoscopy. This may be, for example, cigarette smoke, perfume, or the smell of paint or diesel. Alternatively, you can ride the bicycle ergometer – depending on whether smells or physical exertion trigger your shortness of breath. If a VCD attack can be triggered in the course of the examination, the paradoxical closure of the vocal cords can be seen, which occurs during inhalation in more than 95 per cent of cases. VCD patients with problems during exhalation are very rare. 

Incidentally, this special diagnostic procedure was jointly developed by our specialists. It is exclusively conducted here at Schoen Clinic.