アレルギーと治療のジャーナル

概要

Vocal Cord Dysfunction after an Inhalation Exposure

Stuart M. Brooks

The manuscript embodies case material and the author’s extensive personal experience to address a perceived or actual airborne exposure when incorrectly judged as due to intrathoracic/lung damage when in reality the outcome is the more innocuous extrathoracic/upper airway’s vocal cord dysfunction (VCD). Because of the conviction of possible lung injury, the individual applies the fetal protective glottic closure reflex to counteract an odorant cue instigating acute VCD. Breathing against an obstructed glottis as well as hyperventilation from anxiety, panic and/or fear of personal harm worsens the laryngeal spasm. Spirometer shows flattening of the inspiratory loop of the flow-volume curve and endoscopy, while not done, would reveal adduction of the anterior two-thirds of the vocal cords with posterior chinking creating a diamond shape configuration. Successful therapy and management of VCD requires a speech therapy approach rather than physician prescribed medications.