CASE REPORT
Psychophysiologic treatment of vocal cord dysfunction

https://doi.org/10.1016/S1081-1206(10)61874-1Get rights and content

Background

Vocal cord dysfunction (VCD) is an obstructive upper airway syndrome that frequently mimics asthma and for which there is no empirical treatment of choice.

Objective

To describe two military service members experiencing VCD who were treated with psychophysiologic self-regulation training.

Methods

Both cases were active-duty military members with VCD confirmed by laryngoscopy They each received biofeedback self-regulation training to decrease tension in the extrinsic laryngeal musculature.

Results

Both patients responded to the treatment, denied the presence of dsypnea, and had resumed military physical training.

Conclusions

Psychophysiologic self-regulation strategies both with and without concurrent speech therapy positively impacted VCD symptoms.

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There are more references available in the full text version of this article.

Cited by (25)

  • Perceptual Clinical Features in Exercise-Induced Laryngeal Obstruction (EILO): Toward Improved Diagnostic Approaches

    2019, Journal of Voice
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    In addition to gaps in identifiable features indicative of ELBD (in general) and EILO (more specifically), there are also gaps in our understanding of etiological mechanisms underlying these clinical presentations. Previous literature has frequently alluded to high stress reactivity and poor temperament/self-regulation as a cause of EILO32–38; these traits have been most commonly attributed to the high-achieving, competitive, and anxious nature in athletes with the exercise variant.36,39 Unfortunately, this theory is largely unsubstantiated due to lack of empirical evidence.

  • Speech-Language Pathology as a Primary Treatment for Exercise-Induced Laryngeal Obstruction

    2018, Immunology and Allergy Clinics of North America
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    In treating EILO, SLPs use various approaches of breathing and relaxation techniques to guide the patient through symptom prevention, control, and rescue breathing during their dyspneic episodes. The literature suggests positive patient response to behavioral intervention for EILO.1–14 It has been reported that behavioral intervention by SLPs may prevent up to 90% of patient visits to the emergency room for symptoms attributable to inducible laryngeal obstruction, although this finding is not specific to patients with exercise-induced symptoms.15

  • Exercise inducible laryngeal obstruction: diagnostics and management

    2017, Paediatric Respiratory Reviews
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    Inhaled ipratropium bromide applied locally prior to activity has been reported to prevent exercise induced VCD [82]. Different forms of biofeedback techniques have been proposed [83,84], as has inspiratory muscle training [85–88]. Laser supraglottoplasty has been used to treat patients with severe supraglottic e-ILO and positive effects have been reported by several research groups [41,52,54–58,69,89–91].

  • Exercise induced Dyspnoea in Sports

    2016, Sports Orthopaedics and Traumatology
  • Laryngeal movements during inspiratory muscle training in healthy subjects

    2013, Journal of Voice
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    There is little robust evidence about effects of intervention to reduce airway obstructions originating in the larynx during exercise. Speech therapy has been reported as a mainstay,6–13 while psychotherapy,14 relaxation therapy,15 hypnosis,16 biofeedback techniques,17,18 anticholinergic aerosols,19 and surgical laser supraglottoplasty20–24 have also been advocated. The common goal of these interventions has been to increase the size of the laryngeal inlet during the increasing airflow velocity induced by increasing exercise intensity.

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The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

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