Inducible Laryngeal Obstruction (ILO)
This is also called vocal cord dysfunction (VCD) and paradoxical vocal fold motion disorder (PVFM). It means that the vocal folds (or any structures above them) move backward during breathing—they come inward during inhalation instead of opening like they are supposed to.
This often occurs because of:
- Strong smells
- Reflux
- Stress
- Talking
- Crumbly foods
- Atmospheric changes
- Exercise
Exercise Induced Laryngeal Obstruction (EILO)
This refers to ILO that only occurs during exercise, especially high-intensity activities. Symptoms include:
- Trouble on the inhale
- A feeling of tightness in the throat
- Quick onset and recovery
- No benefit from inhalers
Breathing Pattern Disorder (BPD)
Another breathing condition, breathing pattern disorder (BPD) or dysfunctional breathing (DB), can occur independently or compound the upper airway conditions previously mentioned. BPD is when breathing is “backwards” and often results in chest/shoulder/throat involvement versus more ideal full-body, diaphragmatic, abdominal-focused breathing.
Symptoms include:
- Breath-holding tendencies
- Sighing
- Gasping
- Chest/shoulder movement on inhalations
- Shallow breathing in general
- Feeling of “air hunger” or inability to get “enough air”
Cough Hypersensitivity Syndrome (CHS)
Another upper airway-related condition is cough hypersensitivity syndrome (CHS), which has also been termed chronic cough, neurogenic cough, irritable larynx syndrome, laryngeal hypersensitivity and laryngeal hyperresponsiveness.
This basically means that the larynx is producing a consistent throat-clearing or cough-related pattern in response to a strong sensory feeling (tickle, tightness, mucus, globus sensation, etc.) and often is set off by a trigger (similar to those listed above or different altogether).
“Although the laryngeal chemoreflex is meant to be protective, the reflex can become hyper stimulated, even to benign stimuli, which can result in pathological disorders, such as chronic cough and inducible laryngeal obstruction” (Pathak et al., 2020).
In a non-productive cough, there is a lack of benefit (of coughing/throat clearing) and a definite presence of negative side effects. Also, remember that the more you cough, the more you may “bring up something,” and it will seem productive.
Behavioral cough suppression therapy (BCST) is the most effective and evidence-based treatment for CHS; the goal is to down-regulate the cough sensitivity reflex through neuroplasticity (make the sensitivity go away) via repetition and consistency. It’s also important to address co-occurring conditions (muscle tension dysphonia, inducible laryngeal obstruction, globus sensation, etc.—as 40% of people also experience these).
Additionally, in collaboration with your physician, neuromodulator medications and/or a superior laryngeal nerve block can also be helpful. It is highly likely (and based on research) that one of these methods or a combination of all three will manage the cough/throat-clearing pattern for good!
For more information or to schedule an appointment with our speech pathology team, please call Roxanna Musko, AOC speech pathology assistant at: (602) 476-5004.