Diagnosis and Management of Vocal Cord Dysfunction

Shannon Munro Cohen, PhD, APRN, BC, FNP


Journal for Nurse Practitioners. 2010;6(9):675-682. 

In This Article

Abstract and Introduction


Vocal cord dysfunction is often incorrectly identified as asthma. Unlike asthma, this condition does not respond to inhalers and affects the upper airway. These patients may present with a sudden onset of inspiratory stridor or wheeze, choking sensation, tightness, or heaviness over the larynx that ends just as abruptly with deep-breathing exercises or distraction. Treatment includes gradual taper and discontinuation of unnecessary asthma medications, diaphragmatic breathing exercises, adequate hydration, nasal saline lavage to reduce postnasal drainage, prevention and treatment of gastroesophageal reflux, and treatment of allergies and chronic sinusitis.


Vocal cord dysfunction (VCD) is often incorrectly diagnosed as difficult-to-treat asthma, has a physiological and psychological component, and is considered a diagnosis of exclusion. Unlike asthma, VCD does not respond to asthma inhalers and affects the upper airway, as opposed to the lungs.[1–3] VCD is defined as a "respiratory disorder that affects closure of the vocal cords during inspiration, resulting in restricted airflow."[4] Nurse practitioners (NPs) have the opportunity to improve patient quality of life and reduce healthcare costs by proper diagnosis and management of this disorder.


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