Throat Symptoms

Do your symptoms include:

• Post nasal drip
• Throat clearing
• Sore throat
• Vocal cord dysfunction
• Voice problems
• Hoarseness
• Tonsils & adenoid recurrent infections
• Snoring
• Bad breath

We can identify these problems and find solutions.

Symptoms in the throat area are common problems seen in our office. Individuals with chronic postnasal drip, throat clearing, persistent sore throat, bad breath, hoarseness and other vocal disturbances (like) snoring issues or difficulty swallowing often come to our offices seeking help. Evaluation of the upper respiratory tract including the nose, throat and voice box through skin testing, radiologic studies of the sinuses, lateral neck, and esophagus, and endoscopic esophagus examinations are very helpful in assessing these types of symptoms. Oftentimes, multiple problems converge causing symptoms from allergies from the upper airway, lymphoid enlargement of the tonsils and adenoids obstructs the airway, and stomach acid reflux (GERD) and/or immune disorders predisposing the patient to recurrent infections. A multifaceted approach assessing allergic inflammation, anatomic obstruction, reflux, and immune disorders are often required to effectively identify the sources of these problems and ultimately proper treatment.

Vocal Cord Dysfunction

The Asthma Center physicians have particular expertise in diagnosing and evaluating a condition called vocal cord dysfunction, which is a medical condition that can mimic asthma but originates in the throat.

Vocal cord dysfunction (VCD) is caused by a restriction of air flow in the upper airway resulting from sudden spasm or constriction of the vocal cords. If you suffer from vocal cord dysfunction, you usually present with symptoms of troubled breathing, throat tightness, whistling in throat area during inspiration, and/or wheezing. Since these symptoms are so similar to those of asthma, it is possible to be initially misdiagnosed as having asthma.

Vocal cord dysfunction results in symptoms when the vocal cords pull together tightly during inspiration (breathing in), thus closing off or narrowing the passageway of the upper airway. This results in symptoms of shortness of breath and noisy breathing due to the restricted air flow, which becomes most prominent during inspiration. Although whistling sounds heard during inspiration may bear some similarity to wheezing, they have a higher pitched quality than the typical wheezing usually heard in asthma and are best heard over the throat/neck, not chest area. In contrast, asthmatic wheezing is most prominent during expiration (breathing out). The sound due to vocal cord dysfunction is most prominent during inspiration (breathing in), and this sound is called stridor.

If you have VCD but have been misdiagnosed with asthma, it is not surprising that you may be treated unsuccessfully with medications designed for asthma. You can be admitted to emergency rooms and even hospitals while continuing to be misdiagnosed and treated for asthma. Failure to recognize vocal cord dysfunction often leads to misuse of more potent asthma medications (e.g. corticosteroids) in an effort to control persistent symptoms. However, it should be noted that occasionally both vocal cord dysfunction and asthma can coexist. In this situation, both respiratory disorders need to be properly recognized and treated simultaneously in order to fully control symptoms.

In addition to difficulty breathing, you may commonly complain of throat tightness, hoarseness and difficulty getting air in more than out. Episodes of vocal cord dysfunction often occur more during the day than at night, while poorly controlled asthma symptoms are often worse at night. Asthma inhalers, nebulizer treatments and even steroids (prednisone) do not help vocal cord dysfunction unless you also have asthma. Vocal cord dysfunction can be triggered by stress, exercise and irritants (like gas, smoke, fumes, dust, cleaning agents, pungent odors, solvents), but in many cases the cause is unknown.

Treatment usually involves working with a speech pathologist and a behavioral therapist. Occasionally Botox® injections temporarily can relax vocal cords.