|
Vocal cord dysfunction (VCD) affects the vocal folds, commonly referred to as the vocal cords, and is characterized by full or partial vocal fold closure that usually occurs for short periods during inhalation but can occur during both inhalation and exhalation.〔Barbara A. Mathers-Schmidt Paradoxical Vocal Fold Motion: A Tutorial on a Complex Disorder and the Speech-Language Pathologist's Role ''Am J Speech Lang Pathol'', May 2001; 10: 111 - 125.〕 ==Presentation== Symptoms can include shortness of breath, dyspnea, wheezing, coughing, tightness in the throat, skin discoloration due to oxygen deprivation (cyanosis), noise during inhalation (stridor), and in severe cases, loss of consciousness. The differential diagnosis for Vocal Cord Dysfunction, also referred to as paradoxical vocal fold motion (PVFM) and paradoxical vocal cord movement (PVCM), includes vocal fold swelling from allergy, asthma, or some obstruction of the vocal folds or throat. Anyone suspected of this condition should be evaluated and the vocal folds (voice box) visualized. In individuals who experience a persistent difficulty with inhaling, consideration should be given to a neurological cause such as brain stem compression, cerebral palsy, etc. "Episodes" can be triggered suddenly or develop gradually and triggers are numerous. Primary causes are believed to be gastroesophageal reflux disease (GERD), extra-esophageal reflux (EERD), exposure to inhaled allergens, post nasal drip, exercise, or neurological conditions that can cause difficulty inhaling only during waking.〔 Published studies emphasize anxiety or stress as a primary cause while more recent literature indicates a likely physical etiology. This disorder has been observed from infancy through old age, with the observation of its occurrence in infants leading some to believe that a physiological cause such as reflux or allergy is likely. Certain medications, such as antihistamines for allergies, cause drying of the mucus membranes which can cause further irritation or hypersensitivity of the vocal cords. VCD can mimic asthma, anaphylaxis, collapsed lungs, pulmonary embolism, or fat embolism, and can lead to an inaccurate diagnosis and inappropriate, potentially harmful, treatment. Some are misdiagnosed with asthma, but are unresponsive to asthma therapy, including bronchodilators and steroids. Among adult patients, women tend to be diagnosed more often. Among children and teenage patients, VCD has been linked with high participation in competitive sports and family orientation towards high achievement. Vocal cord dysfunction co-occurs with asthma approximately 40% of the time.〔 This frequently results in a misdiagnosis of only asthma. Even young children can tell the difference between an asthma attack (primarily difficulty exhaling) and a VCD attack (primarily difficulty inhaling). Knowing the difference between the two will help those who have both know when to use the rescue inhaler prescribed or when to use the breathing recovery exercises trained by a speech language pathologist. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Vocal cord dysfunction」の詳細全文を読む スポンサード リンク
|