Zusammenfassung
Als Vocal Cord Dysfunction (VCD) bezeichnet man eine Fehlfunktion der Stimmlippen mit intermittierendem inspiratorischem Kehlkopfverschluss. Bei 2 Patientinnen mit anfallsweisen Atemnotattacken, z. T. mehrfach täglich, sowie einer Patientin mit angeblicher beidseitiger Rekurrensparese diagnostizierten wir eine VCD als Ursache. Die flexible Videolaryngoskopie und -stroboskopie zeigte während einer Atemnotattacke bei Inspiration eine beidseitige Stimmlippenadduktion mit ausgeprägter Glottisengstellung. Je nach Ursache wurde anders therapiert: Vermittlung adäquater Atemtechniken zur Reduktion der Atemnotsymptomatik, intralaryngeale Botulinumtoxinapplikation und Behandlung mit dem Protonenpumpeninhibitor Omeprazol. In allen Fällen besserte sich die Symptomatik deutlich. Bei unklaren asthmatischen Beschwerden sollte differenzialdiagnostisch auch eine VCD als Ursache erwogen werden. Sicher lässt sich die Diagnose meist nur endoskopisch während einer provozierten Atemnotattacke stellen.
Abstract
Vocal cord dysfunction (VCD) is described as a functional disorder of the vocal folds which leads to an intermittent, inspiratory ‘paradoxical’ glottal closure. We report on three women with frequent repetitive shortness of breath attacks caused by VCD. This was diagnosed by transnasal videofiberendoscopy, with glottal closure being seen during inspiration. Because of the different etiologies, one of the patients was treated with breathing and speech therapy, another received Omeprazol for laryngopharyngeal reflux, and the third was treated by intralaryngeal botulinum toxin injections. All three patients showed a reduction in attacks. Clinically, VCD seems to mimic asthma. However, with a thorough patient history and diagnostics, especially with transnasal laryngoscopy during a (triggered) attack, a precise diagnosis seems possible.
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Kothe, C., Schade, G., Fleischer, S. et al. Vocal Cord Dysfunction. HNO 52, 261–264 (2004). https://doi.org/10.1007/s00106-003-1023-7
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DOI: https://doi.org/10.1007/s00106-003-1023-7