Upper Airway Disorders, Hyperresponsive Larynx

What are upper airway disorders and hyperresponsive larynx?

Individuals with hyperresponsive laryx can experience disorders of their upper airway which impact their voice, breathing and swallowing.

The larynx is the vestibule of the airway and the vocal folds (vocal cords) are the doorway to the lower airway, sitting just above the trachea.  When the fragile tissue of the larynx become inflamed or irritated due to exposure to stomach acid, allergens, smoke or environmental pollution our bodies can respond with maladaptive behaviors in an effort to protect our airway.  For example, our vocal folds may initiate an airway protective response to turbulent air, temperature changes, odors and attempt to close upon inhalation in an effort to protect the airway.  When this happens, we feel short of breath to varying degrees, noting the obstruction to our airflow.   This is known as Paradoxical Vocal Fold Motion o(VFM) or Vocal Cord Dysfunction (VCD) and generally requires rehabilitation to resolve symptoms.  Another airway protective mechanism is cough and inflamed and irritated vocal folds may cough without provocation or when encountering normal variations in environment.   This eventually can become a faulty motor pattern or habit and result in Chronic Cough requiring rehabilitation therapy to resolve. 

Types of upper airway disorders include the following:

• Paradoxical Vocal Fold Motion Disorder (PVFM) / Vocal Cord Dysfunction (VCD) (link to page)
• Chronic cough / chronic throat clearing (link to page)
• Muscle Tension Dysphonia
  • Hoarse, strained or breathy vocal quality
• Acid Reflux (LPRD / GERD) (link to page)
• Globus Sensation / Throat Pain
  • Sensation of something in the throat when nothing is there
• Long COVID (link to page)
• Muscle Tension Dysphagia
  • Difficulty swallowing due to significant tension in the muscles of the pharynx and larynx
• Respiratory Dystonia (link to page)
• Obstructive Sleep Apnea (link to page)

Speech-Language Pathology Evaluation & Therapy

Our Speech-Language Pathologists (SLP), have specialty training and expertise breathing disorders.  The SLP complete a personalized assessment of your breathing and laryngeal health. Assessment will include:

• A detailed history collection
• Laryngeal Function Studies consisting of computerized voice analysis and airway measures
• Behavioral voice and communication analysis (as needed)
• Education and trials of rescue breathing strategies

SLP treatment may include some or all of the following:

• Learn strategies to manage and overcome breathing attacks
• Learn suppression and breathing strategies to minimize persistent coughing or throat clearing (if this is a problem for you)
• Strengthen the inspiratory and expiratory muscles used for breathing
• Reduce laryngeal irritation through optimal voice use
• Laryngeal manipulation, massage and stretches to reduce muscle tension
• Voice therapy
• Dysphagia (swallowing) therapy

Other Treatments for Hyperresponsive Larynx include:

• Pharmacological treatment for laryngopharyngeal reflux (LPRD) also known as silent reflux as frequently hypersensitive it the only symptom
• Pharmacological treatment for allergies.

Treatment for hyperresponsive larynx can be multifactorial.