OBJECTIVES: Several etiologies for vocal cord dysfunction (VCD), a syndrome of dyspnea, noisy breathing, and inspiratory vocal cord closure are suggested; there is no consensus on the predisposition to its development. One previously identified psychiatric etiology is combat stress. METHODS: A retrospective review of military personnel evaluated at Landstuhl Regional Medical Center with a new VCD diagnosis post-deployment was conducted. Medical records were reviewed for existing pulmonary, sinus, esophageal, or psychiatric disorders and determined their VCD evaluation. RESULTS: Forty-eight patients were identified with VCD symptoms after combat deployment. For military personnel with VCD, symptoms were associated with several etiologies. Fifty-two percent reported symptoms were related to high stress/anxiety, whereas 39% reported symptoms during exercise; 16% had onset with acute respiratory illness and 7% were trauma related. The combination of a truncated inspiratory flow volume loop and negative methacholine challenge had a 72% positive predictive value. CONCLUSIONS: Common etiologies with VCD onset during deployment are anxiety/stress, exercise, or combination of factors. Spirometry with abnormal flow volume loop plus negative methacholine challenge testing offers a reasonable predictive value for diagnosing VCD. For deployed military with these findings, laryngoscopy for upper airway disorders should be conducted. Reprint &
OBJECTIVES: Several etiologies for vocal cord dysfunction (VCD), a syndrome of dyspnea, noisy breathing, and inspiratory vocal cord closure are suggested; there is no consensus on the predisposition to its development. One previously identified psychiatric etiology is combat stress. METHODS: A retrospective review of military personnel evaluated at Landstuhl Regional Medical Center with a new VCD diagnosis post-deployment was conducted. Medical records were reviewed for existing pulmonary, sinus, esophageal, or psychiatric disorders and determined their VCD evaluation. RESULTS: Forty-eight patients were identified with VCD symptoms after combat deployment. For military personnel with VCD, symptoms were associated with several etiologies. Fifty-two percent reported symptoms were related to high stress/anxiety, whereas 39% reported symptoms during exercise; 16% had onset with acute respiratory illness and 7% were trauma related. The combination of a truncated inspiratory flow volume loop and negative methacholine challenge had a 72% positive predictive value. CONCLUSIONS: Common etiologies with VCD onset during deployment are anxiety/stress, exercise, or combination of factors. Spirometry with abnormal flow volume loop plus negative methacholine challenge testing offers a reasonable predictive value for diagnosing VCD. For deployed military with these findings, laryngoscopy for upper airway disorders should be conducted. Reprint &
Authors: Ida Jansrud Hammer; Thomas Halvorsen; Maria Vollsaeter; Magnus Hilland; John-Helge Heimdal; Ola Drange Røksund; Hege Havstad Clemm Journal: Scand J Med Sci Sports Date: 2022-02-08 Impact factor: 4.645