“VCD does not exist,” says E.N.T. physician Dr. Stacey Silvers.
Dr. Silvers, of Madison ENT & Facial Plastic Surgery in NYC, who is board certified in otolaryngology, explains that “No one has done EMG on vocal muscles to show that the nerve is not functioning during these sudden ‘episodes.’”
An EMG (electromyography) is a nerve conduction test to see how well, if at all, electrical nerve impulses are firing to make muscle fibers contract.
So then, just what is going on when someone experiences what they believe to be a problem or “dysfunction” with their vocal cords?
Dr. Silvers explains, “The symptoms of ‘VCD’ are the exact symptoms of silent reflux. It is the swelling from the acid leading to the scary symptoms. It is not paralysis or weakness of the vocal cords.”
Silent reflux is also known as LPR (laryngopharyngeal reflux disease).
The term “vocal cord dysfunction” is actually ambiguous. What Dr. Silvers is saying is that there truly is a disorder suffered by many that involves the vocal cords: LPR.
But this is not a problem with the muscle fibers of the vocal cords. Hence, the term “vocal cord dysfunction” is misleading.
“VCD is a misnomer,” says Dr. Silvers. “The symptoms of difficulty breathing, coughing, wheezing, throat tightness, hoarse voice are all symptoms of LPR.
“The term VCD has been coined by allergists and pulmonologists who do not have the ability to view the vocal cords.”
You may have read somewhere that a doctor can look down your throat and diagnose VCD, but that in order for the doctor to do this, the patient would have to be experiencing an “attack” right at that moment. What are the odds of that occurring?
LPR can produce ongoing symptoms such as throat discomfort, the hoarse voice, very frequent coughing, a sensation of mucus trickling down the throat and a constant feeling of a lump in the throat.
But that sudden “attack” of feeling that your airway has instantly been shrunk to the diameter of a straw … it’s just not likely that this will occur right when the physician is peering down at your vocal cords.
And if it did…the doctor would see acid on the vocal cords making them swell.
“The symptoms can be sudden; they can wake you from sleep and make it feel like you cannot breathe,” says Dr. Silvers.
“Laryngopharyngeal reflux is acid coming up into the back of the throat. The throat (laryngeal or post cricoid) swelling is a result of the acid irritating the tissues leading to swelling.
“Therefore, people experience throat tightness and hoarseness. It’s the swelling of the larynx and even just below the larynx that is a result of the corrosive stomach acid that leads to the wheezing and throat tightness.
“These patients are not developing a nerve issue or vocal function problems. If the reflux is treated, the symptoms will resolve.”