Multidisciplinary approach to an adolescent with vocal cord dysfunction: case report

Yıl 2022, , 40 - 48, 31.03.2022

Yavuz Meral , Ayse Ayzıt Kılınç , Burak Doğangün

https://doi.org/10.55517/mrr.1017764

Öz

Vocal Cord Dysfunction (VCD) causes improper adduction of vocal cords resulting in audible wheezing and stridor over the larynx. The etiology of VCD is not clear, however, it has been viewed as a complex and heterogeneous disorder in which psychogenic factors might also have a critical role. We present the 14-years-old female with VCD, asthma, and gastroesophageal reflux disease. Her condition was resistant to medical treatment and speech therapy. A psychiatric evaluation revealed that several dynamics consistent with somatic symptom disorder. Cognitive Behavioral Therapy (CBT) oriented 5 sessions of intervention resulted in symptom relief successfully. Child and adolescent psychiatrists can play a facilitating role in the optimal treatment of VCD regarding the multifactorial aspects of the condition.

Anahtar Kelimeler

cognitive behavioural therapy, somatic symptoms, vocal cord dysfunction

Vokal kord disfonksiyonu olan bir ergene multidisipliner yaklaşım: olgu sunumu

Öz

Vokal Kord Disfonksiyonu (VKD), ses tellerinin uygun olmayan şekilde kapanmasına neden olarak gırtlak üzerinde duyulabilir hırıltıya ve stridora yol açar. VCD'nin etiyolojisi net değildir, ancak psikojenik faktörlerin de kritik rol oynayabileceği karmaşık ve heterojen bir bozukluk olarak görülmüştür. Bu vakada VCD, astım ve gastroözofageal reflü hastalığı olan 14 yaşında adölesan hasta sunulmaktadır. Tıbbi tedaviye ve konuşma terapisine dirençli olan olguda yapılan psikiyatrik değerlendirme, somatik semptom bozukluğu ile uyumlu çeşitli dinamikleri ortaya çıkarmıştır. Bilişsel Davranışçı Terapi (CBT) odaklı 5 seanslık müdahale, semptomların başarıyla giderilmesini sağlayarak psikiyatrik yaklaşımların VCD'nin optimal tedavisinde kolaylaştırıcı bir rol oynayabileceğine işaret etmektedir.

Anahtar Kelimeler

bilişsel davranışçı terapi, somatik belirtiler, vokal kord disfonksiyonu

Kaynakça

• Stoltz LP, Fajt ML, Petrov AA, Traister RS. Vocal Cord Dysfunction: A Review. Clin Pulm Med. 2018;25(4):125–30.
• Bahrainwala, A. H., & Simon, M. R. (2001). Wheezing and vocal cord dysfunction mimicking asthma. Current opinion in pulmonary medicine, 7(1), 8-13.
• Newman KB, Dubester SN. Vocal cord dysfunction: Masquerader of asthma. Seminars in Respiratory and Critical Care Medicine. 1994.
• Christopher KL, Morris MJ. Vocal cord dysfunction, paradoxic vocal fold motion, or laryngomalacia? Our understanding requires an interdisciplinary approach. Otolaryngol Clin North Am. 2010;43(1):43–66.
• Petrov AA. Vocal Cord Dysfunction: The Spectrum Across the Ages. Immunol Allergy Clin. 2019;39(4):547–60.
• Leo, R. J., & Konakanchi, R. (1999). Psychogenic respiratory distress: a case of paradoxical vocal cord dysfunction and literature review. The Primary Care Companion for CNS Disorders, 1(2), 22857.
• Rundell KW, Weiss P. Exercise-induced bronchoconstriction and vocal cord dysfunction: two sides of the same coin? Curr Sports Med Rep. 2013;12(1):45–50.
• Allan PF, Abouchahine S, Harvis L, Morris MJ. Progressive vocal cord dysfunction subsequent to a chlorine gas exposure. J Voice. 2006;20(2):291–6.
• McQuaid EL, Spieth LE, Spirito A. The pediatric psychologist’s role in differential diagnosis: vocal-cord dysfunction presenting as asthma. J Pediatr Psychol. 1997;22(5):739–48.
• Richards-Mauzé MM, Banez GA. Vocal cord dysfunction: Evaluation of a four-session cognitive–behavioral intervention. Clin Pract Pediatr Psychol. 2014;2(1):27–38.
• Forrest, L. A., Husein, T., & Husein, O. (2012). Paradoxical vocal cord motion: classification and treatment. The Laryngoscope, 122(4), 844-853.
• Campo J V, Jansen-McWilliams L, Comer DM, Kelleher KJ. Somatization in pediatric primary care: association with psychopathology, functional impairment, and use of services. J Am Acad Child Adolesc Psychiatry. 1999;38(9):1093–101.
• Brugman SM, Howell JH, Rosenberg DM, Blager FB, Lack G. The spectrum of pediatric vocal cord dysfunction. Am J Respir Crit Care Med. 1994;149(4):A353.
• Guglani L, Atkinson S, Hosanagar A, Guglani L. A systematic review of psychological interventions for adult and pediatric patients with vocal cord dysfunction. Front Pediatr. 2014;2:82.
• Maturo S, Hill C, Bunting G, Baliff C, Ramakrishna J, Scirica C, et al. Pediatric paradoxical vocal-fold motion: presentation and natural history. Pediatrics. 2011;128(6):e1443–9.