Vocal cord dysfunction in a child.

摘要: Vocal cord dysfunction (VCD) involves paradoxical adduction of the vocal during respiratory cycle. This usually occurs inspiration, but can also be seen in expiration. appositioning produces airflow obstruction sufficient to cause wheezing, shortness breath, chest tightness, and coughing. These symptoms often imitate alterations asthma, thus leading inappropriate treatment; intubation or tracheotomy may prove necessary. An 11-year-old girl was admitted with intractable dyspnea. She had been diagnosed atopic although she failed respond an increase antiasthma medication, including high-dose oral steroids. Flow-volume loops were abnormal, evidence variable extrathoracic airway obstruction, manifested as a flat inspiratory loop. No structural abnormalities either computed tomography (CT) magnetic resonance imaging (MRI). Fibroscopy revealed cords cycle, no obstructive disorder being observed. After diagnosis VCD, clinical manifestations resolved psychiatric treatment. Adduction not demonstrable at repeat fibroscopy after VCD simulate bronchial asthma; it associated that disorder, masking diagnosis. It should suspected patients recurrent wheezing who fail usual asthma treament. early avoids unnecessary aggressive management. Treatment consist phonatory exercises; psychotherapy useful.