Vocal cord dysfunction as demonstrated by impulse oscillometry

Vocal cord dysfunction (VCD) is a respiratory disorder characterized by inappropriate vocal cord adduction during inspiration. The diagnosis of VCD is challenging, because expected flow volume loop abnormalities are uncommonly noted, and laryngoscopy must be timed to coincide with symptoms. We wante...

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Published inThe journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 1; no. 4; p. 387
Main Authors Komarow, Hirsh D, Young, Michael, Nelson, Celeste, Metcalfe, Dean D
Format Journal Article
LanguageEnglish
Published United States 01.07.2013
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Abstract Vocal cord dysfunction (VCD) is a respiratory disorder characterized by inappropriate vocal cord adduction during inspiration. The diagnosis of VCD is challenging, because expected flow volume loop abnormalities are uncommonly noted, and laryngoscopy must be timed to coincide with symptoms. We wanted to determine the potential role of impulse oscillometry (IOS) in the diagnosis of VCD. We conducted an analysis of six patients in which the diagnosis of VCD was being considered as well as seven healthy subjects and five subjects with asthma. All were evaluated with IOS and spirometry, and patients underwent laryngoscopy. Two patients with suspected VCD who did not exhibit symptoms or abnormal pulmonary function at baseline underwent exercise challenge and repeat studies. One patient with suspected VCD underwent an additional irritant challenge. VCD was diagnosed by laryngoscopy in three of the six patients in whom the diagnosis of VCD was entertained. These three patients as a group all exhibited higher amplitude (mean, 9.3 cm H20/L/second) and more variable spikes (SD, 4.8 cm H20/L/second) on IOS impedance during inspiration, whereas the three patients in whom the diagnosis was not confirmed by endoscopy did not show these findings (mean, 2.0 cm H20/L/second; P < .0002; SD, 0.8 cm H20/L/second; P < .0001). This pattern was also not observed in the healthy volunteers (mean ± SD, 1.8 ± 0.7 cm H20/L/second) and patients with asthma at baseline (mean, 4.2 ± 1.2 cm H20/L/second) or after exercise challenge (mean, 1.5 ± 0.5 cm H20/L/second). These findings support the conclusion that IOS displays a characteristic pattern in patients with VCD and thus may offer a rapid and noninvasive adjunct to the assessment and diagnosis of patients suspected to have this disorder.
AbstractList Vocal cord dysfunction (VCD) is a respiratory disorder characterized by inappropriate vocal cord adduction during inspiration. The diagnosis of VCD is challenging, because expected flow volume loop abnormalities are uncommonly noted, and laryngoscopy must be timed to coincide with symptoms. We wanted to determine the potential role of impulse oscillometry (IOS) in the diagnosis of VCD. We conducted an analysis of six patients in which the diagnosis of VCD was being considered as well as seven healthy subjects and five subjects with asthma. All were evaluated with IOS and spirometry, and patients underwent laryngoscopy. Two patients with suspected VCD who did not exhibit symptoms or abnormal pulmonary function at baseline underwent exercise challenge and repeat studies. One patient with suspected VCD underwent an additional irritant challenge. VCD was diagnosed by laryngoscopy in three of the six patients in whom the diagnosis of VCD was entertained. These three patients as a group all exhibited higher amplitude (mean, 9.3 cm H20/L/second) and more variable spikes (SD, 4.8 cm H20/L/second) on IOS impedance during inspiration, whereas the three patients in whom the diagnosis was not confirmed by endoscopy did not show these findings (mean, 2.0 cm H20/L/second; P < .0002; SD, 0.8 cm H20/L/second; P < .0001). This pattern was also not observed in the healthy volunteers (mean ± SD, 1.8 ± 0.7 cm H20/L/second) and patients with asthma at baseline (mean, 4.2 ± 1.2 cm H20/L/second) or after exercise challenge (mean, 1.5 ± 0.5 cm H20/L/second). These findings support the conclusion that IOS displays a characteristic pattern in patients with VCD and thus may offer a rapid and noninvasive adjunct to the assessment and diagnosis of patients suspected to have this disorder.
Author Komarow, Hirsh D
Nelson, Celeste
Metcalfe, Dean D
Young, Michael
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Issue 4
Keywords Vocal cord dysfunction
laryngoscopy
asthma
spirometry
impulse oscillometry
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Snippet Vocal cord dysfunction (VCD) is a respiratory disorder characterized by inappropriate vocal cord adduction during inspiration. The diagnosis of VCD is...
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StartPage 387
SubjectTerms Adolescent
Child
Electric Impedance
Female
Humans
Laryngoscopy
Male
Middle Aged
Oscillometry
Vocal Cord Dysfunction - diagnosis
Title Vocal cord dysfunction as demonstrated by impulse oscillometry
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