Vocal cord dysfunction

Thursday, December 9, 2010






Disorder and post vocal cords

Disorder and post vocal cords, which are commonly know paradoxical vocal fold movement, characterized by rounded abnormal folds during the respiratory cycle (especially during the inspiratory phase), this disorder results in obstruction to air flow at the level of the larynx.
May be treated in most cases without response to treatment - allergy was
And disorder and post vocal cords in most cases, like asthma, persistent and he has treated in most cases without response to treatment - allergy released - with high doses of corticosteroid inhaler or destruction, and bronchodilators, and through multiple visits to the emergency department, and admitted to hospital, and in some cases, the work of the cutdown tracheal (windpipe incision), and put a tube.
In some cases, the work of the cutdown tracheal (windpipe incision)


Born disease

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      During the session, the natural respiratory vocal cords diverge partly with air to breathe, and partially converge with the end of the exhale, and allow the movement of the vocal cords - without obstruction - the entry of air into the lungs and out of it. While maintaining Psahlkip alveoli of the lungs, through the provision of respiratory positive pressure during exhalation (end-expiratory pressure positive or, and it is the throat valve first airways to help keep the lungs in the case of expansion, and throat rich supply of the nervous system and help to do its job, and the Activation of striated muscle and under voluntary control and reflex regulates the size, as well as both the nerve cells of the larynx and motor neurons affects the size of the glottis, and are also influenced by the activity vagal reflex that originates from receptors to the lungs and throat.
      Picture speculum examination of the normal throat
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      Mechanism that causes the narrowing gap oboe or intermittent closure during inspiration independent of any changes in the measurement of respiratory tract lower is not known, and when the people affected by the post-ROMs folds stop accidental, leading to bouts of acute intermittent disability or obstruction career paths respiratory, and be signs and symptoms similar to those that are observed in disorders such as paralysis of vocal cords, and asthma, inflammation of the epiglottis and laryngeal spasm, and vascular Alodomp resulting from anaphylactic shock.
      Development of vocal cords in a patient function vocal cords Anthae inspiration
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      Described recent reports of some cases, other reasons for disorder vocal cords of the larynx, such as the entrance to a different area of the status attached to the mucosa of the upper part of the esophagus, and exposure to a substance like Algelotharaladhead, and inhalation of swimmers and divers of chlorine.
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      Disorder appears to function as part of the vocal cords strikes respiratory tract caused by exposure because of occupation or profession, which include exposure to the exciting stuff, and psychological stress, which occurs Kadtrapat transformative in some people.
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      Remember One theory is that the vagus nerve may alter the tension laryngeal and reduces the threshold level of the stimuli to occur contraction Balohbal audio, or deposition rounding non-natural folds, and what has been written on this subject suggests a greater emphasis to the causes of membership such as Gastro-oesophageal reflux, and reflux laryngopharyngeal and that's where the laryngeal pharynx is very sensitive to raise stomach acid.

Spread of the disease

These cases are about 10% of patients who are on the assessment of their cases as cases asthma popular and which do not respond to treatment, and reveals the literature on this subject for a disturbance vocal cords when people with cases of psychological (such as depression, and Obsessive Compulsive Disorder and Personality Disorder borderline, and neuroses resulting from sexual abuse in childhood), and people who have increased body mass index and staff medical professionals, and may be a disruption of the vocal cords asthma complications at a small number of patients.


Morbidity and mortality

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      Do not know the mortality rates.
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      Disorders occur due to use of corticosteroids for long periods such as the syndrome are similar to Cushing disease, and loss of bone density, and inhibition of growth in children.

Sex-related disease
Notes the existence of this disease primarily in women, where the ratio between the patients in this situation are 3 women for every man almost.


Age-related disease
These cases are prevalent in the age period 20-40 years, but it is possible to occur between the ages 6-83 years, and recent literature to suggest an increase among children and adolescents.


Symptoms

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      Burr.
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      Cough / cough.
      Feeling of tightness in the throat
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      Feeling of tightness in the throat.
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      The presence of hoarseness, changing voice.
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      Occurrence of stridor (high pitched voice).
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      Shortness of breath.
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      Shortness of breath with stress
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      Difficulty of inspiration.
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      Sudden bouts of shortness of breath.
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      Failure to respond to Extenders bronchi and corticosteroid preparations.

Tags
Hear the buzzing sound on the chest

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      Hear the sound of the larynx can reveal the existence of a chirping sound during the presence of symptoms.
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      Could be heard buzzing sound on the chest (which is narrated from the upper respiratory tract).

Reasons
Problems that accompany the disorder and the function of vocal cords include the following:

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      Gastro-oesophageal reflux and laryngopharyngeal reflux.
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       Inflammation of the upper respiratory tract (such as rhinitis, or sinusitis, viral infections or recurrent).
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      Violent exercise.
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      Inhalation exposure to the exciting stuff is accidental or exposure by virtue of employment.
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      Exposure to Mstorjat (what is causing the allergy) or environmental contaminants.
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      Psychological reasons of origin (such as severe stress).

Tests
Laboratory tests:

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      Count of eosinophils of white blood cells do not increase in cases of disorder and functions of vocal cords (which do not address the corticosteroid for extended periods), while more than in similar cases such as asthma, which increases when these cells by more than 5%.
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      Measurement of arterial blood gases be in the normal range in patients with vocal cords disorder, while showing hypoxemia in patients with asthma.

Radiology tests:

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      X-rays are normal, while showing excessive swelling of the lungs when the disease asthma.
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      Rays may be used to assess lung diseases, or diseases of the throat, or heart, which may explain, or support the symptoms suffered by the patient.

Other tests:

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      Measure supports the diagnosis of respiratory disorder vocal cords in patients who complain of symptoms.
      Spirometry
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      Plans breathing is the most that indicate that the distinction between disorder and post vocal cords and bronchial asthma, as it shows lack of flow of air inhalation in patients with disorder and post vocal cords, also shows a sudden drop and rise in the volume of air flow during the presence of symptoms and in the absence of a cough.
      Plans breathing
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      For patients whose physical activity is the catalyst for the disturbance and their function vocal cords, the physical activity staging a cause of heart
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      The work of skin sensitivity test may detect some cases of nasal allergies, asthma or allergic

Interventions

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      Work speculum examination of the larynx is the standard for the diagnosis of disorder and post vocal cords, where they are deliberately vocal cords in the abnormal convergence during inhalation.
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      Image shows the vocal cords during the examination of the telescope nearly two-thirds of the anterior vocal cords, also found a gap in the form of an urgent - in the back and the hole through which air flows during inspiration.

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      In the absence of symptoms during endoscopic examination of the patient may occur when the audio changes Balohbal work effort athlete, or increased breathing, or work a maximum inspiration followed by forced exhalation fast.

Treatment

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      Multidisciplinary treatment is effective when you need him, which includes treatment by a physician, and specialist treatment of pronunciation, and psychiatrist.
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      Speech therapy includes mainly training the patient to work relaxed the cords sound, and exercises for breathing, and in difficult cases this does treatment with psychological support associated with, and the role of the specialized treatment of pronunciation learning is impressive, and communicate through a treatment plan including the bands, with exercises suitable for breathing.
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      The role of psychotherapy is cognitive behavior therapy, or psychotherapy-General based on an assessment of psychological disorder, or personality disorder.
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      Recent studies show that psychological treatment for the disorder self-directed physical shape, and transformational disorders may increase the efficiency of treatment, when added to conventional therapy.
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      The patient is given a mixture of helium and oxygen, and the mixture is less dense than air, so it reduces the turbulence during inhalation, which is given the benefit of only the short term, but it can be helpful in emergency treatment for the disorder and the function of vocal cords.
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      Injection Sefan botulism symptoms of laryngeal released by disabling the start of acetylcholine, causing weakness of throat muscles, and facilitates the flow of air inhaled and exhaled.
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      Desperately cause relaxation of vocal cords and increase the converging of the glottis.
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      Put lotion topical laryngeal lidocaine, which reduces the contraction of muscles of the glottis and supraglottic.

Medical advice
The patient needs the advice of a specialist ear, nose and throat, and lung disease specialist, and a specialist allergy and immunology, and specialized treatment of pronunciation, and psychiatrist.


Food
There is no need to ban any type of foods.


Drugs
There is no specific drugs recommended giving it to the patient.


Follow-up
Is the follow-up the patient after discharge from the hospital, in order to determine a response to learning and speech therapy, and assess the extent of need for psychological care by a specialist.


Prevention
Prevention can be provided through the following guidelines for speech therapy, exercise, relaxation therapy, and other means


The fate of the disease
The fate of the disease is well with the response to speech therapy, which allows the patient to control the disorder.


Patient Education

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      The education of the patient through a variety of specialists, including a doctor, specialist speech therapy and a psychiatrist.

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