[Vocal cord dysfunction, an important differential diagnosis of severe and implausible bronchial asthma]

Pneumologie. 1997 Jan;51(1):14-8.
[Article in German]


Background: For asthmatics who show-despite of all available therapeutic efforts-an unsatisfactory clinical course in- or exspiratory vocal cord dysfunctions are an important diagnostic consideration. Aside from some case reports, there is only one major study, presenting a prevalence of > 30% in subjects admitted because of refractory asthma.

Patients and methods: The question was whether this phenomenon could also be found in our patients, mostly in- or extrinsic asthmatics. In cases suspicious for VCD or with an unexplainable asthma course, we performed videotaped laryngoscopy, including exposure to questionable provocing irritants.

Results: In 14 months, we detected VCD in 16 patients by laryngoscopy and spirometry at the time of severe dyspnea. Subjects were predominantly women. Our therapeutical approach included: explanation of their videotape, speech therapy, breathing techniques and psychological support. In patients, pretreated with systemic corticosteroids, the dose could be reduced remarkably. A benefit 3 month after diagnosis could be shown using a life-quality-questionnaire.

Conclusions: Screening for VCD in patients with unplausible, refractory asthma and other unexplained dyspnea- or wheezing attacks is an important diagnostic consideration in order to prevent unnecessary medical treatment or drug related side-effects and to introduce a specific therapeutical concept.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Asthma / diagnosis*
  • Asthma / etiology
  • Diagnosis, Differential
  • Female
  • Humans
  • Laryngismus / diagnosis*
  • Laryngismus / etiology
  • Male
  • Middle Aged
  • Vocal Cords*