Laryngospasm is a sudden constriction of the vocal cords that impairs breathing or speaking, often associated with GERD. Treatment involves preventing acid production and relaxation techniques, with surgery as a last resort. Education and medical care for contributing conditions are important.
In medicine, a laryngospasm is a sudden constriction of the vocal cords that impairs an individual’s ability to breathe or speak. Momentary in onset, this rare event often occurs in individuals who have been diagnosed with gastroesophageal reflux disease (GERD). Treatment for this often episodic condition focuses on prevention and generally involves the use of a drug to inhibit stomach acid production.
Often associated with GERD, a laryngospasm can also be idiopathic, meaning there is no obvious cause for its occurrence. Precipitated by the constriction of the adductor muscles, laryngospasm occurs as a defense mechanism to protect the airways from a foreign substance, such as a drink of water going down in the wrong direction. In some cases, there may be nothing trying to enter the airways, but a mild sensation could be misinterpreted as triggering the closure of the vocal cords.
Although laryngospasmodic episodes may be short-lived, the intense feelings of tightness and anxiety may be enough to knock some individuals unconscious. Common signs of acute laryngospasm include audible breathing accentuated by a decreased ability to inhale. Individuals with GERD symptoms generally experience signs including chest discomfort, coughing, and heartburn before a vocal cord spasm. Once the spasm eases and the airways open, an individual may demonstrate a form of high-pitched audible breathing known as stridor.
It has been stated that vocal cord spasms can also occur as a post-operative complication. Irritation of the vocal cords, induced by an inflammatory substance, can trigger an episode of laryngospasm. The vocal cords of individuals with GERD are constantly exposed to stomach acid, which can cause chronic inflammation contributing to the development of more frequent spasms. The presence of respiratory infections can also contribute to the introduction of irritants into the larynx which can also trigger a spasm of the vocal cords.
Treatment for a vocal cord spasm usually involves administering medications to inhibit the production of stomach acid, which works to relieve the symptoms of GERD and the spasms of the larynx. There is no established medical treatment designed specifically to treat vocal cord spasms, so, in addition to the use of preventative medications, individuals are encouraged to learn relaxation techniques to relieve laryngeal constriction. When preventative measures offer no relief, surgery can be used to reduce the frequency of laryngospasm episodes. Surgical repositioning of the upper portion of the stomach relative to the esophagus, a common procedure known as a fundoplication, can be done to relieve GERD symptoms and reduce the risk of recurrent episodes of laryngospasm.
In severe cases, the placement of a tracheostomy button can be used specifically to relieve laryngospasm-induced symptoms when they occur. The artificial opening and the plastic tube require conscientious maintenance to ensure that both remain operational and clean, meaning both are free of clogging mucus and phlegm. Placing a tracheostomy button can also come with significant activity and lifestyle restrictions.
Above all, education is key to the proper management of episodic vocal cord spasms. Individuals are often encouraged to inquire about warning signs of episodes and available treatment options. Adequate medical care for existing contributing conditions is also helpful in reducing the occurrence of the episode and the severity of symptoms.
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