Vocal cord dysfunction: two case reports.

Vocal cord dysfunction is an uncommon condition characterised by adduction of vocal cords that can masquerade as or coexists with bronchial asthma. The glottic dysfunction is due to a functional (non-organic) cause. If unrecognised, incorrect diagnosis may result in patients being unnecessarily treated as refractory or severe asthma with high doses of corticosteroid. This may result in unwarranted steroid toxicity. Clues that should raise clinical suspicion to the diagnosis of vocal cord dysfunction include lack of response to bronchodilators, poor reproducibility of spirometric indices due to inconsistent effort and truncation of the inspiratory limb of the flow-volume loop. Definitive diagnosis is made by direct visualisation of the vocal cords during an attack. We report two patients with vocal cord dysfunction and review the literature on this disorder.