A Novel Scoring System to Distinguish Vocal Cord Dysfunction From Asthma

Traister, Russell S.; Fajt, Merritt L.; Landsittel, Douglass; Petrov, Andrej A.

doi:10.1016/j.jaip.2013.09.002

Cited by 105 publications

(58 citation statements)

References 13 publications

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“…A typical symptom of VCD is hoarseness during attacks. Patients may be screened for VCD with the Pittsburgh questionnaire [75], and referral to a speech pathologist should be considered. VCD may also be provoked by exercise.…”

Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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“…As Chevalier Jackson (an American pioneer in laryngology) often quoted, “not all that wheezes is asthma.”2 PVFMD is often misdiagnosed as asthma, which leads to the inappropriate choice of treatment options for subjects with this condition 3. Undiagnosed PVFMD has been shown to lead to immense health care costs where there are reports of unnecessary intubations and tracheostomies performed in these cases1 and increased asthma medication usage 4. One study found that 42.4% of patients with PVFMD were misdiagnosed with asthma for, on average, 9 years 4.…”

Section: Introductionmentioning

confidence: 99%

“…Undiagnosed PVFMD has been shown to lead to immense health care costs where there are reports of unnecessary intubations and tracheostomies performed in these cases1 and increased asthma medication usage 4. One study found that 42.4% of patients with PVFMD were misdiagnosed with asthma for, on average, 9 years 4. Although the exact prevalence of PVFMD is not known, it is estimated that the rate of incidence is between 2.5% and 26.9% 3.…”

Section: Introductionmentioning

confidence: 99%

The forgotten cause of stridor in the emergency department

2017

OAEM

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Paradoxical Vocal Fold Movement Disorder is where the larynx exhibits paradoxical vocal cords closure during respiration, creating partial airway obstruction. Causes of vocal fold movement disorder are multifactorial, and patients describe tightness of throat, difficulty getting air in, have stridor, and do not respond to inhalers. We propose using transnasal laryngoscopy examination, which will show narrowing of vocal cords on inspiration, and The Pittsburgh Vocal Cord Dysfunction Index with a cutoff score of ≥4 to distinguish vocal fold movement disorder from asthma and other causes of stridor. Management of paradoxical vocal fold movement disorder involves a combination of pharmacological, psychological, psychiatric, and speech training. Paradoxical vocal fold movement disorder is a very treatable cause of stridor, so long as it is identified and other organic causes are excluded.

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“…About one-third of patients with severe asthma have abnormal laryngeal movement on CT, but it is unclear if this is a cause or consequence of asthma. He described the four-question Vocal Cord Dysfunction (VCD) Index, which is useful for discriminating VCD from asthma, and proposed that vocal cord assessment will soon become routine with the use of portable devices and involvement of multidisciplinary teams 65. New techniques for the treatment of VCD, such as laser supraglottoplasty and unilateral botox injection, need RCT assessment.…”

Section: Introductionmentioning

confidence: 99%