User:I.anastacia/sandbox

Prognosis
Currently, the natural prognosis of VCD in both children and adults is not well described in literature. Additionally, there is currently no research that has studied whether the underlying cause of VCD makes a difference in the resolution of symptoms or in the long-term prognosis of the impairment.

Information on the prognosis of VCD after acute therapies is also limited. Minimal response has been documented with the continued treatment of asthma in people with VCD using inhaled bronchodilators, corticosteroids and other asthma medications. While using Botox in VCD has limited reports, those that are available report successful resolution of exercise-induced VCD symptoms for up to 2 months.

Outcomes of chronic VCD treatment are similarly limited. When pediatric patients undergoing hypnosis therapy were studied, more than half saw either a reduction or resolution of VCD. Even though it is widely used, no long-term studies have been done to study the prognosis of VCD after psychotherapy.

Speech therapy is the main course of treatment for long-term management of VCD and includes a variety of techniques such as relaxed-throat breathing, respiratory retraining therapy, and vocal hygiene counselling. Most studies agree that symptoms of VCD improve in patients and few continue to require asthma medications six months post speech therapy intervention. Significant improvements were reported for respiratory retraining therapy, including fewer episodes of dyspnea per month and decreased respiratory stress severity.

For those adolescent patients who recovered from VCD, the average time before the symptoms were resolved was 4-5 months. However, some adolescents had VCD symptoms even 5 years post VCD onset, regardless of intervention. It has been noted that some patients do not respond to standard VCD therapies and continue to express recurrent symptoms.

Risk Factors
The following increase an individual's chances for acquiring VCD:
 * 1) Upper airway inflammation (allergic or non-allergic rhinitis, chronic sinusitis, recurrent upper respiratory infections)
 * 2) Gastroesophageal reflux disease
 * 3) Past traumatic event that involved breathing (e.g. near-drowning, suffocation)
 * 4) Severe emotional trauma or distress
 * 5) Female gender
 * 6) Playing a wind instrument
 * 7) Playing a competitive or elite sport

References to Add to VCD Article
Doshi, D. R., & Weinberger, M. M. (2006). Long-term outcome of vocal cord dysfunction. Annals of Allergy, Asthma & Immunology, 96(6), 794-799. - a retrospective medical chart review of VCD prognosis

Patel, R. R., Venediktov, R., Schooling, T., & Wang, B. (2015). Evidence-Based Systematic Review: Effects of Speech-Language Pathology Treatment for Individuals With Paradoxical Vocal Fold Motion. American Journal Of Speech-Language Pathology, 24(3), 566-584. doi:10.1044/2015_AJSLP-14-0120 - has info on psychological factors as well

Morris, M. J., Allan, P. F., & Perkins, P. J. (2006). Vocal cord dysfunction: etiologies and treatment. Clinical Pulmonary Medicine, 13(2), 73-86.