Asthma is a very common health condition. Most people are quite familiar with it; if not experiencing asthma themselves, most people have family members, friends or acquaintances who suffer from asthma. While asthma itself is often misunderstood, a frequently accompanying condition is even less well known and less well-understood. This condition is vocal cord dysfunction.

What is vocal cord dysfunction? Well, let’s start with what the vocal cords do, where they are located and how they work. The vocal cords form the barrier between the larynx (the bottom of the throat, below the mouth) and the opening of the trachea (the large breathing tube that connects the lungs with the upper portion of our airway. The obvious purpose of the vocal cords — well, they help people talk. They resonate, or vibrate, as we blow air across them. People can change how their voice sounds if they adjust the tone of the muscles that support the vocal cords to either tighten or relax. Of course, much of the rest of speech is governed by the tongue, the lips, the mouth, the teeth and so on. But, without the vocal cords we don’t really talk. The vocal cords do other things that are also very important. For example, if the body senses that food is going “down the wrong tube,” in other words, going into the larynx instead of heading into the esophagus (the swallowing tube) the vocal cords can slam shut and help stop at least some of the food or drink from going where it shouldn’t go. They also play an important role in coughing and other important functions.

However, like other parts of the body, the vocal cords sometimes misbehave. In people with asthma or exercise-induced asthma, the vocal cords sometimes get involved to worsen the condition, probably more often than we recognize. Ordinarily, while breathing, the vocal cords open up and stay out of the way. If they pull shut during breathing, it can really mess things up by making the airway very narrow, to whatever degree the vocal cords are closed.

This is the process that happens with vocal cord dysfunction. In vocal cord dysfunction, the vocal cords pull shut (or “spasm shut”) while a person tries to breathe. This is usually worse in situations where the vocal cords get irritated, such as if breathing in cold air, dry air or exercising, in which rapid airflow can dry and irritate the vocal cords. Other irritants, such as strong perfumes or colognes, cigarette smoke, exhaust fumes and strong household cleaners, can all lead to acute closing or “spasm” of the vocal cords, potentially causing severe breathing symptoms that can come on very suddenly.

Situations in which the vocal cords are irritated, such as from chronic acid reflux (yes, this really happens) or post nasal drip, can lead to vocal cords that are much more likely to misbehave and pull shut or spasm during breathing, especially if exposed to other irritating situations such as exercise or chemical irritants. It seems that asthma itself can lead to changes that can trigger the closing of the vocal cords with breathing, probably because the brain or body think that somehow this might help overcome the limitation to breathing with asthma. Unfortunately, these vocal cord changes with breathing during asthma don’t help, but, rather, make the breathing situation worse, sometimes much worse.

The good news? Well, vocal cord dysfunction can usually be treated quite successfully. The most important factors in treatment appear to be addressing underlying factors that contribute, such as post nasal drip or acid reflux. Also, as asthma is better treated, any associated vocal cord dysfunction tends to improve as well. There are also breathing exercises that can be done for vocal cord dysfunction. These typically are surprisingly simple but can be very helpful.

If you have questions about, or if you think you may suffer from vocal cord dysfunction, asthma or related issues, please schedule an appointment.