Treatment Options For Vocal Cord Dysfunction

Vocal cord dysfunction is a disorder where an individual's vocal cords are unable to function normally. A healthy individual has vocal cords that open up when they breathe air in and out, where individuals affected by vocal cord dysfunction have vocal cords that close. It is more difficult for air to enter and then leave the patient's lungs because of this abnormal vocal cord closing. Respiratory infections, odors, fumes, smoke, post-nasal drip, acid reflux, stress, intense emotions, and exercise can cause an individual to develop vocal cord dysfunction. 

An individual with vocal cord dysfunction may experience shortness of breath, chest tightness, frequent cough, excessive throat clearing, choking sensation, wheezing, noisy breathing, and a hoarse voice. Vocal cord dysfunction can come on suddenly, reducing the concentration of oxygen in the blood.

Speech Therapy

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A patient experiencing vocal cord dysfunction may need to have speech therapy with a certified therapist. The vocal cords in an individual are essentially two bands of limber and stretchy tissue. Because these tissues can be conditioned to adjust to changes, speech therapy is often successful in treating vocal cord dysfunction. An affected individual learns how to perform certain breathing exercises and other methods to help relax the muscles around their throat and vocal cords. 

These types of techniques can be used to manage the symptoms that occur in vocal cord dysfunction, such as shortness of breath, noisy breathing, and a hoarse voice. During speech therapy, an affected individual is asked to run or jog on a treadmill to induce their vocal cord dysfunction symptoms so they can actively work with the certified speech therapist to learn ways to help alleviate them. It typically takes between three and four sessions of speech therapy for an individual to really learn how to control their vocal cord dysfunction effectively.

Deep Breathing Exercises

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An individual affected by vocal cord dysfunction may be taught how to do certain deep breathing exercises to help relax the muscles in their throat. Some breathing exercises that may help with the immediate acute vocal cord dysfunction symptoms are breathing primarily through the nose, breathing diaphragmatically, breathing through a tube or straw, breathing through pursed lips, and making a hissing sound upon exhaling air from the lungs. 

Another breathing exercise involves the use of helium and oxygen called heliox, but it is only used in individuals severely affected by vocal cord dysfunction. Some of these breathing exercise methods are effective for strengthening the function of the vocal cords in the long term. These exercises can help keep the individual's vocal cords open when they inhale air, instead of spontaneously closing and producing vocal cord dysfunction symptoms. Deep breathing exercises can help reduce the number of future symptomatic episodes of chronic vocal cord dysfunction.

Biofeedback

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Biofeedback is a type of therapy that utilizes specialized sensors that attach to an affected individual's body to show provide them with specific information about how their body works. A patient with vocal cord dysfunction can benefit from this type of feedback because they can develop better control over specific functions of their body processes. Biofeedback is a good treatment option for individuals who have chronic vocal cord dysfunction brought on by mental or emotional stress. 

Biofeedback helps an individual manage their stress by the use of techniques to relax certain muscles and manage certain functions in the body. An individual learns how to consciously influence their heart rate, breathing, temperature, and other body functions considered involuntary in such a way that allows them to overrule the natural responses their body has to stressors. Biofeedback is a method many patients choose to utilize because it does not involve medication.

Avoiding Irritants

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Vocal cord dysfunction patients may be advised to avoid irritants or environments that contain certain irritants to manage and treat their condition effectively. Physical irritant triggers of vocal cord dysfunction tend to be similar to the irritant triggers in asthma. Strong odors or fragrances in candles, perfumes, cleaning products, air fresheners, vaporizers, and soaps are known to be irritants. Cigarette smoke, cigar smoke, wood smoke, coal smoke, and other types of smoke have also proven to cause flare-ups of vocal cord dysfunction. 

Environmental factors like high and low temperature and variations in humidity also may cause an individual to have an episode of vocal cord dysfunction symptoms. Certain actions can also trigger vocal cord dysfunction, including excessive laughing, coughing, sneezing, singing, shouting, and crying. Avoiding all of these irritants can reduce an individual's symptom frequency and severity.

Stress Management

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Because any form of excessive stress can cause the development and trigger vocal cord dysfunction, an affected individual may be advised to practice skills in coping and stress management. When an individual's body becomes overburdened by mental, emotional, or physical stress, their body inappropriately implements a mechanism to shut it down. The vocal cords close to stop air from entering into the lungs. When an individual experiences stress, the body responds with a surge of hormones that implement numerous physiological changes, including increased heart rate, elevation in blood pressure, increased temperature, and numerous others. 

In addition to these changes, individuals with vocal cord dysfunction experience a spasmatic and inappropriate closing of their vocal cords. Stress management techniques can be used to minimize it as a factor for causing episodes of vocal cord dysfunction. Yoga, meditation, talk therapy, breathing exercises, and the use of certain anxiety medications has proven to help individuals who have stress-induced vocal cord dysfunction.

Psychotherapy

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An individual affected by vocal cord dysfunction may need to have psychotherapy as a component of their treatment, because as discussed, stress is a common underlying factor in many cases of vocal cord dysfunction. Psychotherapy is known to help patients find healthy and effective ways to cope with stress so it does not affect their body physically. Some form of vocal cord dysfunction can be triggered by exercise and other physical activities. Performance psychotherapy has also proven to show efficacy in the treatment of vocal cord dysfunction in these individuals. 

Psychotherapy is also helpful for patients who have vocal cord dysfunction because they can learn to be more aware of their everyday body posture and learn how to encourage the relaxation of their throat muscles. Psychotherapy can help patients with reducing their mental and physical sensitivities to exercise, certain temperature changes, specific odors, and other triggers of their vocal cord dysfunction. If a patient's vocal cord dysfunction is partially caused by problems with anxiety, a psychotherapist can prescribe and monitor the use of benzodiazepines.

Managing Asthma

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When treating vocal cord dysfunction, managing underlying conditions that can be more serious should be the first approach. Asthma is a long-term disease that affects a patient's airways, which are responsible for transporting air to and from both of their lungs. The airways or bronchial tubes that lead to the lungs become swollen, narrow, and inflamed as a result of asthma. The inflammation of the airways can cause muscles in the patient's neck and throat to malfunction and tighten excessively. 

Asthma attacks have also been known to stimulate an overproduction of mucus in the airways. The swelling and excessive mucus can stop sufficient amounts of oxygen from reaching the patient's lungs because they are not able to breathe very well. These breathing malfunctions and inflammatory mechanisms can cause the adduction of the vocal cords. Inhaler medications can be utilized to help reduce the asthma symptoms that are known to trigger vocal cord dysfunction.

Managing Gastroesophageal Reflux Disease

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Gastroesophageal reflux disease is a disorder of the digestive system where the lower esophageal sphincter does not function the way it should. As a result of this malfunction, gastric acids that are native to the stomach inappropriately flow upward into the patient's esophagus. This process produces painful and uncomfortable symptoms that may include difficulty swallowing, the sensation of a lump in the throat, chest pain, burning sensation in the chest, regurgitation of food, chronic cough, laryngitis, and disrupted sleep. 

Gastroesophageal reflux disease can stimulate a pathogenic mechanism referred to as laryngeal hyper-responsiveness. Laryngeal hyper-responsiveness can cause symptoms of vocal cord dysfunction. However, these symptoms can be mediated upon the treatment of gastroesophageal reflux disease with the use of medication or surgical procedures.

Medication For Allergies Or Anxiety

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Medication to treat anxiety or allergies may be required as part of a patient's treatment for vocal cord dysfunction. Both allergies and anxiety can be potent triggers of the malfunction of the vocal cords. Anxiety can cause patients to breathe abnormally, which may result in the inappropriate constriction of their vocal cords. Anxiety has also been known to produce tremors in some patients' vocal cords that also trigger symptoms of vocal cord dysfunction. Allergies can easily precipitate symptoms of vocal cord dysfunction because of the mechanisms and processes involved in the throat during allergic reactions. 

Allergens come in contact with an affected individual's mucous membranes, which causes the tissues in the throat and neck to become inflamed, swollen, and secrete an excessive amount of mucus. All of these reactive components can induce the malfunction of the vocal cords, producing the symptoms frequently seen with vocal cord dysfunction. Controlling allergies with medications like antihistamines and anxiety with medications like citalopram can help reduce the frequency of vocal cord dysfunction symptoms.

Continuous Positive Airway Pressure

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Continuous positive airway pressure (CPAP) is a method of treatment for breathing disorders that continuously blows air into the lungs while the patient is sleeping. The patient's brain is consistently reinforced to hold the vocal cords apart when they are sleeping as a result of the persistent positive airflow from the device. The positive airflow into the lungs also keeps the brain and body from believing it is drowning, which stimulates the adduction of the vocal cords. Continuous positive airway pressure is only used for patients who experience laryngospasm attacks when they are sleeping at night. 

Using a CPAP machine involves wearing a mask over the face during sleep that exerts air pressure according to the parameters set by the patient's physician. It can take between several weeks and months to determine the right settings to treat a patient's laryngospasm attack precipitated vocal cord dysfunction. The use of a CPAP machine is not effective for all patients who use it, so other treatment methods may be needed.

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