Patients with vocal cord dysfunction typically present with recurrent episodes of subjective respiratory distress that are associated with inspiratory stridor, cough, choking sensations, and throat tightness.3 The presence of wheezing can indicate an asthma exacerbation, but is commonly a mistaken description of the stridor characteristic of vocal cord dysfunction.9,10 In one study, 59 percent of patients with vocal cord dysfunction had been previously diagnosed with asthma.8 Most patients with vocal cord dysfunction have intermittent and relatively mild symptoms, although some patients may have prolonged and severe symptoms. 297-302.News release, FDA. lidocaine in a dose of 1.52 mg kg 1 given Stimulation at a light depth of general anesthesia (laryngoscopy, extubation, blood or secretions irritating vocal cords), Volatile anesthetics (desflurane > isoflurane > halothane = sevoflurane), Multiple attempts at supraglottic airway insertion or direct laryngoscopy in patients in the lighter planes of anesthesia, Age Infants and young children are at greatest risk, Asthma up to 10-fold increased risk with active asthma, Recent upper respiratory infection (up to 6 weeks) up to 10-fold increased risk, Second-hand smoke exposure up to 10-fold increased risk in children, Gastroesophageal reflux, obstructive sleep apnea, Airway anomalies: subglottic stenosis, laryngeal papilloma, cleft palate, vocal cord paralysis, laryngomalacia, tracheal stenosis, Shared airway: tonsillectomy and adenoidectomy (> 20% incidence), bronchoscopy, Thyroid surgery: from superior laryngeal nerve injury or hypocalcemia, Esophageal endoscopy: stimulation of distal afferent esophageal nerves, Others: appendectomy, hypospadias repair, skin grafting, cervical dilatation. route as appropriate. A 41-year-old member asked: Why do children have more laryngospasm than adults? Specific muscles are highlighted in red. You can also relieve GERD and LPR, and help prevent laryngospasm, by following these lifestyle tips: Breathing techniques including slow breathing and staying calm also may help. IV nitroglycerin (4 mcg/kg) also has been found to reverse laryngospasm. They may also give you a long-acting bronchodilator to help reduce your risk of bronchospasms in the future. One study showed decreased incidence of laryngospasm in pediatric patients who were 2014. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The following may increase your risk for laryngospasm: Your healthcare provider may treat conditions that increase your risk for laryngospasm, such as acid reflux. succinylcholine is essentially an i.m. Elsevier; 2020. https://www.clinicalkey.com. After maturation of the cortical centres, they grow out of this tendency. Gavel G, Walker RWM. Recognition and Management of Exercise-Induced Bronchospasm. You may be referred to a doctor trained in ear, nose and throat disorders. Succinylcholine is the drug of choice if propofol fails to relieve laryngospasm, although many may prefer to use succinylcholine as first line. A person may suddenly awaken feeling as though they are suffocating. Mild hoarseness. Do not eat two to three hours before bedtime. Help should be requested if required. After ruling out other causes of airway obstruction, if laryngospasm is suspected, a clear plan of action and good communication is critical for improving patient outcomes (Figure 3). Common airborne irritants associated with vocal cord dysfunction include ammonia, dust, smoke, soldering fumes, and cleaning chemicals. https://www.enthealth.org/conditions/hoarseness/. If possible, an anaesthetic should be delayed for at least 4 weeks after an upper respiratory tract infection (URTI) for that reason. Gastroesophageal reflux disease (GERD) has been implicated in triggering vocal cord dysfunction.19 In some studies, a high prevalence of GERD was identified in patients with vocal cord dysfunction20; however, treatment of GERD was only effective in decreasing vocal cord dysfunction in some patients. If within 60 seconds the condition worsens, or if the person exhibits other symptoms (such as their skin going pale), dont assume that theyre having a laryngospasm. Laryngospasms are often a symptom of an underlying condition. 2014;14(2): 47-51. Bruch JM, et al. Neuroleptic drugs, specifically phenothiazines, may cause transient vocal cord dysfunction. Advertising revenue supports our not-for-profit mission. However, research is ongoing and more evidence is needed in this area. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Further support of the airway may be required with tracheal intubation (especially when airway soiling or pulmonary oedema has occurred). Laryngospasm: Causes, Treatment, First Aid, and More - Healthline ensuring a clear larynx, that is, checking for blood or stomach contents; relieving any possible supra-glottic component to the airway obstruction; As part of the initial treatment, a vigorous jaw thrust will lift the tongue off the pharyngeal wall and potentially help lift the supraglottic tissues from the false vocal cords. Less Common Causes. Medically reviewed by Drugs.com. Postanesthesia Care Unit Simulation This content does not have an English version. Vocal Cord Dysfunction | AAFP

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