Understanding Upper Airway Disorders
When your vocal cords inappropriately close during breathing, causing sudden shortness of breath and throat tightness that mimics asthma.
Inducible Laryngeal Obstruction (ILO), Paradoxical Vocal Fold Motion (PVFM), and Vocal Cord Dysfunction (VCD) describe conditions where the vocal cords inappropriately narrow or close during breathing—particularly on inhalation. This creates sudden episodes of breathing difficulty, throat tightness, noisy breathing (stridor), and a choking sensation that can be frightening and debilitating.
These upper airway disorders are frequently misdiagnosed as asthma because symptoms appear similar: shortness of breath, wheezing, and respiratory distress. However, unlike asthma medications which target the lower airways, ILO/PVFM/VCD affects the upper airway at the level of the larynx (voice box), requiring specialized speech therapy intervention rather than solely medical management.
Seek Medical Assessment If
Get medical evaluation immediately if you experience:
- Sudden severe breathing difficulty requiring emergency care
- Blue lips or fingertips during breathing episodes
- Breathing difficulty not responding to asthma inhalers
- Loss of consciousness during breathing episodes
Speech Therapy Indicators
Consider upper airway disorder therapy when:
- Inspiratory wheeze (noisy breathing IN)
- Throat tightness or choking sensation
- Triggered by exercise, stress, or strong odors
- Asthma medications provide limited relief
ILO/PVFM/VCD vs Asthma: Understanding the Difference
Why Misdiagnosis Happens
Upper airway disorders and asthma share similar symptoms—shortness of breath, wheezing, and respiratory distress. However, they affect different parts of the airway and require different treatments. Many patients try multiple asthma medications with limited success before discovering their breathing difficulty originates from the vocal cords rather than the lungs.
Features Suggesting ILO/PVFM/VCD
- Inspiratory stridor (noisy breathing in)
- Throat tightness or choking sensation
- Triggered by odors, exercise, or stress
- Voice changes during episodes
- Poor response to asthma inhalers
Typical Asthma Features
- Expiratory wheeze (noisy breathing out)
- Chest tightness rather than throat
- Allergies, pollen, or weather triggers
- Normal voice quality
- Good response to asthma medication
Important Note: Co-existence
Some patients have both upper airway disorders AND asthma simultaneously. This requires coordinated management addressing both conditions. Our hospital-trained expertise enables us to work effectively with your respiratory physicians and ENT specialists for comprehensive care.
Speech Therapy: The Gold Standard Treatment
Evidence-based speech pathology is recognized as first-line treatment for inducible laryngeal obstruction and related upper airway disorders.
Comprehensive Assessment
Detailed evaluation of breathing patterns, triggers, laryngeal tension, and voice quality. We identify specific patterns contributing to your upper airway obstruction episodes.
Respiratory Retraining
Evidence-based breathing techniques to reduce laryngeal hyperreactivity and prevent paradoxical vocal fold closure during breathing episodes.
Laryngeal Relaxation
Techniques to reduce throat tension and promote normal vocal fold movement during breathing, reducing frequency and severity of episodes.
Our Treatment Techniques
- Rescue breathing techniques for acute episodes
- Diaphragmatic breathing for respiratory control
- Progressive laryngeal tension reduction exercises
- Trigger identification and management strategies
- Anxiety and stress management techniques
- Exercise protocols for athletes and active individuals
- Environmental modification and exposure strategies
- Home exercise programs for ongoing management
Multidisciplinary Approach to Upper Airway Disorders
ILO, PVFM, and VCD benefit from coordinated care across multiple healthcare specialties.
Hospital-Trained Collaboration
Our practitioner's 15-year Te Whatu Ora background enables effective collaboration with ENT specialists (laryngoscopy diagnosis), respiratory physicians (differential diagnosis), and psychologists (anxiety management). We speak the clinical language necessary for seamless care coordination.
We provide comprehensive reports to your medical team, attend multidisciplinary meetings when appropriate, and ensure all aspects of your upper airway disorder receive expert attention.
Diagnosis and Confirmation
Laryngoscopy by an ENT specialist is the gold standard for confirming ILO/PVFM/VCD, visualizing paradoxical vocal fold movement during provocation testing. Pulmonary function tests may show characteristic inspiratory flow limitation.
We work closely with specialists to interpret findings and develop coordinated treatment plans combining speech therapy (first-line treatment) with medical management when necessary.
We Collaborate With
- ENT Specialists (Laryngology)
- Respiratory/Pulmonary Physicians
- Allergists and Immunologists
- General Practitioners
- Psychologists (Anxiety/Stress)
- Sports Medicine Physicians
Frequently Asked Questions
How is upper airway disorder diagnosed?
Laryngoscopy by an ENT specialist during symptom provocation is the gold standard, directly visualizing paradoxical vocal fold movement. Pulmonary function tests may show inspiratory flow limitation. We work closely with ENT and respiratory physicians for accurate diagnosis and coordinated treatment.
How long does treatment take?
Most patients see significant improvement within 2-6 sessions over 4-8 weeks. You'll learn rescue breathing techniques in the first session. Athletes and exercise-induced cases may require additional sessions for sport-specific protocols. Some patients achieve complete symptom resolution, while others develop excellent episode management skills.
Can I continue my asthma medication?
Yes, absolutely. If you have confirmed asthma in addition to upper airway disorder, continue your prescribed asthma medications. Speech therapy addresses the laryngeal component while medical management controls the asthma component. We coordinate with your respiratory physician for optimal combined treatment.
Is telehealth effective for upper airway disorder therapy?
Yes, telehealth is highly effective for ILO/PVFM/VCD treatment. We can observe breathing patterns, demonstrate techniques, and provide real-time feedback via video. Many athletes and busy professionals prefer telehealth for convenient access to specialized care without travel disruption.
Take Control of Your Breathing
Evidence-based speech therapy for upper airway disorders. Your story matters, and gentle specialist expertise makes all the difference.
Hospital Expertise
NZSTA registered, Te Whatu Ora trained
Evidence-Based Care
Gold standard treatment protocols
Nationwide Access
Wellington clinic + telehealth NZ