Vocal cord dysfunction (VCD) is a condition in which the vocal cords do not function properly during breathing. Although it may cause symptoms similar to those of asthma, including wheezing and labored breathing, the two conditions differ.

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During standard breathing, the vocal cords remain open to allow air to pass through. In people with VCD, or paradoxical vocal fold movement, the vocal cords close, making breathing difficult.

Although VCD can cause discomfort, many treatment options are available to correct improper breathing.

This article looks at what occurs in VCD, its symptoms, and how they differ from those of asthma. It also discusses the causes of VCD and the current treatment options.

In the human throat, air travels through the larynx. This structure is crucial for controlling air pressure to support proper breathing.

The primary functions of the larynx are:

  • voice production
  • protection of the airway during respiration
  • swallowing

Various muscles, including the vocalis, are attached to the larynx. They have a specialized epithelium covering that is essential to the vibratory function.

Repeating pulses of air cause vibrations through the vocal cords. These pulses and vibrations travel through the throat to create vocal sounds, such as speech or singing.

However, in people with VCD, the vocal cords close during the breathing process. This is known as adduction. Mild cases of VCD may make breathing difficult, while more severe cases can also have a negative effect on an individual’s voice.

Research suggests that episodes of VCD can vary in frequency, depending on the individual. Some people only experience VCD in reaction to certain triggers, whereas others may experience VCD symptoms more often.

Some of the symptoms of VCD are similar to those of asthma. These symptoms include:

Individuals experiencing these or other symptoms should consult a doctor to learn more about their condition.

Vocal cord dysfunction vs. asthma

The symptoms of VCD are similar to those of asthma. This sometimes makes it difficult for doctors to distinguish between the two conditions.

Unlike VCD, asthma involves a tightening of the bronchial tubes. These tubes allow air to pass from the windpipe to the lungs. Asthma is a type of allergic response related to immune system problems.

People with VCD frequently receive an erroneous asthma diagnosis. They may only undergo evaluation for VCD after failing to respond to asthma treatments, such as bronchodilators.

A person may also have both VCD and asthma, as these conditions can occur together.

In a 2016 study, females were more than twice as likely as males to experience VCD. Individuals with severe or difficult-to-treat asthma also had a higher risk of developing VCD.

The cause of VCD remains poorly understood and can vary among individuals. Possible causes include:

Other factors that may contribute to a VCD episode include:

The exact cause of VCD is unknown, and it is difficult to diagnose given its similarity to other conditions. People should consult a doctor, who can review any symptoms and rule out other possible diagnoses.

Some doctors will diagnose VCD using pulmonary function tests.

These tests examine breathing and lung function. They can also rule out asthma as the cause of VCD-like symptoms. However, not everyone with VCD will require these tests.


One pulmonary function test is spirometry. This test measures airflow during inhalation and exhalation. During spirometry, a person breathes into a mouthpiece that delivers air into the spirometer device.

This device measures the volume of air that the person breathes in and out. It also examines the rate at which breathing occurs. The results can help healthcare professionals determine whether an individual has VCD.

Sometimes, doctors will perform spirometry when diagnosing asthma.

Flexible laryngoscopy

Another test that can help diagnose VCD is a flexible laryngoscopy. In this test, a doctor inserts a flexible device called a laryngoscope into the nose. This long, thin device travels through the nose and into the throat.

As it travels through the throat, a camera on the laryngoscope sends images back to a monitor. Images of the vocal cords can reveal signs of VCD.

If a structural problem is present, this suggests an alternative diagnosis to VCD. Sometimes, doctors perform exercise-induced testing in which they induce an episode and assess its motion.

In most cases, VCD treatment centers on speech therapy. A speech-language pathologist (SLP) will educate the person about VCD and how it affects their body.

They will also teach the person breathing exercises to reduce tension across the shoulders, neck, and throat. Certain breathing strategies can also help stop a VCD episode more quickly. For instance, a person can try:

  • breathing with a relaxed throat
  • panting
  • pursing the lips when breathing

Individuals with VCD can work with an SLP to develop better breathing habits., which can help improve VCD symptoms.

Alongside speech therapy, doctors will teach diaphragmatic breathing. In many medical settings, ear, nose, and throat (ENT) specialists and SLPs jointly run a designated voice clinic where a person can receive a diagnosis and treatment.

Other treatments

Another treatment option for VCD is visual biofeedback therapy, which allows individuals with VCD to observe the images from a laryngoscopy in real time.

People who can visually observe their breathing patterns can make adjustments to their breathing based on these images. At-home practice can help maintain these changes.

However, this type of therapy requires multiple resources, so it is not an option at every clinic.

Some people can also develop VCD in response to irritants or pollutants. Identifying and avoiding VCD triggers can help reduce or eliminate symptoms for these individuals.

Learn more about air pollutants and common lung irritants.

If psychological conditions are a factor in VCD, treating these will likely be an important part of treatment. For instance, a person may benefit from attending therapy sessions or taking medications for anxiety or depression.

Although VCD affects the coordination of the vocal cords, they are still able to move. Outside of episodes, people breathe and talk with ease. Treatment can also relieve the symptoms that occur during episodes.

Vocal cord paralysis is a different condition that causes either one or both of the vocal cords to malfunction. The affected cords do not close or open normally.

If the vocal cords do not move and are in a closed position, a person will have difficulty breathing.

If the vocal cords are in an open position, a person will have issues with aspiration and a weak voice. If only one cord does not move, aspiration and voice may not be an issue, but this will depend on relative vocal cord position and overall tone.

Some people with vocal cord paralysis may regain function and respond fully to speech therapy. However, some individuals may require surgery to alter their vocal cord positioning.

Learn more about neck and throat surgeries.

Although VCD can cause a range of symptoms, most people with this condition have a complete response to treatment. In many cases, speech therapy alone is sufficient for VCD recovery.

Adjusting the home and workplace environments to avoid VCD triggers can also eliminate the symptoms. With the right medical support, individuals with VCD can manage or reduce their symptoms.

VCD involves a dysfunction of the vocal cords during breathing. It can cause symptoms such as coughing or labored breathing.

There is no known cause of VCD, but environmental irritants or stressful events may trigger the symptoms. Certain imaging tests can help doctors diagnose VCD and determine the best treatment approach.

In most cases, speech therapy and improved breathing habits effectively treat VCD. With suitable medical support from an ENT specialist, VCD symptoms can improve or disappear over time.