The voice box is located in the center of the neck. Two structures making up this box are the vocal chords, which are two folds of tissue that protrude from the sides of the box to form a narrow slit that allows air to pass through. When air passes between the vocal chords they vibrate, producing speech, song, and all other vocal noises. An alteration in the vocal chords or in their nerve supply caused by disease can interfere with sound.

If the vocal chords become dysfunctional, they can produce a wheeze. Usually a wheeze develops when there is a constriction of the small tubes known as bronchi in the lung. This condition is usually referred to as asthma. Wheezing can also result from dysfunctional vocal chords.

If you have been diagnosed as having asthma but are not responding to medications that usually control this condition, the wheezing may be due to vocal chord dysfunction and should be evaluated by an ear, nose and throat (ENT) specialist. Many people who have been treated for asthma for many years have been found to have vocal chord dysfunction (VCD), which requires different treatments.

Signs of VCD include:

  • Difficulty breathing in
  • Wheezing after exercise
  • Wheezing that does not respond to bronchodilators (medications that reduces the spasms of the small tubes in the lungs)
  • Chest x-rays do show signs that are usually seen in people with asthma
  • Pulmonary test reveals that the person has difficulty inhaling
  • Direct visualization of the vocal chords by an ENT physician reveals vocal chord dysfunction
  • Extension of the neck lessens the respiratory distress
  • A mixture of helium (70%) and oxygen (30%) may interrupt an episode of vocal chord dysfunction.

Speech therapy and psychological counseling may be helpful. Controlling one’s breathing pattern by relaxing the muscles in the neck, shoulders and chest are also helpful.

Remember, if your asthma is not being relieved with the usual medication used for asthma, you may be experiencing wheezing related to an abnormality in your vocal chords. Be more vocal in seeking treatment. Even if it sounds like asthma and feels like asthma, it may not be asthma!

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