F. 37 years old, woman, underwent a phoniatric and allergy examination following a diagnosis of vocal cord dysfunction, after having intermittently manifested symptoms compatible with this disorder over the last 9 years.
In the past, her allergist had thought it was all caused by an asthma disorder and had treated it as such, with the result, however, of continuous relapses until the last major episode led to her being admitted to hospital in cause breathing difficulties. There she was examined by an ENT who found a particular movement of the vocal fold characteristic of chordal dysfunction. The ENT examination also showed signs of reflux for which a pump inhibitor drug was prescribed. F. was then referred to an allergist for allergy and asthma evaluations. Allergy testing demonstrated mild asthma, present along with chordal dysfunction. In the end it was deemed appropriate to also have a consultation with a speech therapist.
F. she knew a speech therapist and preferred to be followed by him for these skills and, fortunately for me, this speech therapist is an acquaintance of mine and she allowed me to collaborate on the case.
The symptoms that F. reported were tightness of the throat and chest followed by vocal stridor and shortness of breath.
Generally speaking, F. did not describe her general state of health as good. When radiographic tests were requested, a cervical fusion was highlighted due to chronic disc degeneration which had already been detected 2 years earlier without complications. F. you had allergies that were treated with immunotherapy. When questioned about any stressful events, she F. reported that she noticed an abnormal level of anxiety when her son started driving a car. However, she denied any conflicts associated with family or work relationships. The osteopathic evaluation revealed a dysfunction affecting the upper thoracic and middle cervical tract (where disc degeneration is also present) with functional irregularity of the laryngeal components and a very backward position of the tongue.
The therapy was therefore based on the application of osteopathic treatment sessions aimed at reducing dysfunctions by rebalancing the synchrony of the individual components and their integration into the global functional system associated with specific visceral work for reflux, followed by physiotherapeutic respiratory re-education. and a speech therapist regarding the lingual component.