Vocal Cord Dysfunction (VCD)

What is Vocal Cord Dysfunction (VCD)?

Vocal Cord Dysfunction, also called Paradoxical Vocal Fold Motion (PVFM) or Inducible Laryngeal Obstruction (ILO), is when the vocal cords don’t fully open when you breathe in, blocking your airways. Vocal cords are muscles located in the larynx (voice box) that vibrate when you breathe out, producing the voice. The symptoms of VCD often mimics asthma.

People with VCD may experience sudden shortness of breath, throat tightness, or a choking sensation. These episodes can be frightening, but they are not life-threatening.

Who Can Develop VCD?

VCD affects people of all ages, including athletes and those with other respiratory or throat conditions. It is more common in women than in men, especially women ages 20 to 40.

Common triggers of VCD include:

Physical exertion (especially during sports or intense activity)
Gastroesophageal reflux disease (GERD)
Post-nasal drip, sinus infections, or allergies
Strong odors, smoke, or other irritants
Emotional stress or anxiety

What Are the Symptoms of VCD?

The symptoms of VCD can come on suddenly and may include:

Difficulty breathing in (especially during activity)
Throat tightness or a feeling of being unable to get air
Noisy breathing (stridor)
Wheezing that doesn’t respond to asthma medications
Coughing, voice changes, or frequent throat clearing

Unlike asthma, VCD symptoms typically improve quickly after the episode ends and do not involve the lungs directly.

UR Medicine's Treatments for Vocal Cord Dysfunction (VCD)

How Is VCD Diagnosed?

Because VCD is often mistaken for asthma, a thorough evaluation is important. Diagnosis may include:

Pulmonary function tests to measure airflow and detect irregular breathing patterns
Video laryngoscopy to observe the vocal cords in action and identify paradoxical movement
Flow-volume loop to show if there’s a blockage in your airways
Evaluation of possible contributing factors like gastroesophageal reflux or allergies
Ruling out other respiratory issues such as asthma or chronic obstructive pulmonary disease (COPD)

How Is VCD Treated?

Treatment focuses on retraining the vocal cords and identifying any underlying triggers for VCD. Most patients improve significantly with therapy, often without the need for medications.

Options include:

Speech therapy: Helps patients learn breathing techniques to help control episodes
Respiratory retraining therapy: Teaches proper breathing patterns during activity and rest
Management of reflux with diet changes or medication such as antacids
Behavioral therapy to address anxiety or stress-related triggers
Avoiding irritants like smoke, dust, or strong smells

What Sets Us Apart?

At UR Medicine, we utilize a multidisciplinary approach to care for children and adults with vocal cord dysfunction. We use state-of-the-art testing and customized therapy plans to help you breathe more easily and confidently.

We are exposed to more complex cases than most providers in the Rochester region, and each of our patients can be assured they are always in the hands of highly skilled experts. We’re here to help you get answers, find relief, and take control of your health.

UR Medicine Voice Center is the only voice center in Upstate New York with a comprehensive team of voice experts, including ear, nose, and throat (ENT) physicians who are fellowship-trained in voice disorders. Our speech pathologists have specialized training to evaluate and treat patients with vocal cord dysfunction. They will work collaboratively with your physician and capitalize on the expertise of multiple disciplines, including GI, Thoracic Surgery, Pulmonology, Otolaryngology, and Neurology to best treat your vocal cord dysfunction.