Multidisciplinary approach to vocal cord dysfunction diagnosis and treatment in one session: a single institutional outcome study.
OBJECTIVE
To determine whether the multidisciplinary approach to the management of vocal cord dysfunction (VCD), which combines patient education and behavioral intervention in the same session that VCD is diagnosed, provides long-term therapeutic benefits.


METHODS
Chart review and telephone interviews of patients treated for VCD at The Children's Hospital of Philadelphia were performed in this retrospective nonrandomized study. All forty patients diagnosed with VCD from October 2007 to April 2009 were included. Patients were evaluated with a multidisciplinary team approach, including speech therapy assessment, otolaryngology exam and flexible laryngoscopy. Patients with VCD were educated about their condition and instructed about breathing techniques in the same session.


RESULTS
Twenty-two patients were available for a phone interview. Mean age of patients was 13.4 ± 3.0 years. Sixteen patients were female. Mean number of clinic visits was 1.3 ± 0.8. Average time between phone interview and first clinical encounter was 14.0 ± 7.2 months. Compliance rate to demonstrate breathing exercises was 90.9%. Nineteen out of 22 patients (86.4%) reported improvement of their symptoms in frequency and/or severity. Six patients (27.3%) sought additional medical advice related to their respiratory symptoms. Twenty-one patients (95.5%) were able to maintain or increase their level of physical activity following clinic visit.


CONCLUSIONS
Combining the diagnostic encounter with multidisciplinary behavioral intervention in a single visit is an efficacious approach for the long-term management of VCD in the pediatric population.
Department of Otolaryngology: Head, Neck Surgery at The Children's Hospital of Philadelphia, Center for Pediatric Airway Disorders, United States.
Anaïs
A
Rameau
Rhonda S
RS
Foltz
Katie
K
Wagner
Karen B
KB
Zur
D000293:Adolescent; D001945:Breathing Exercises; D002648:Child; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000628:therapy*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015143:Philadelphia; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013070:Speech Therapy; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology*; D055815:Young Adult