Abstract
To the Editor,
I read with great interest the article by White et al, “Characterization of 68 Consecutive Pediatric Vocal Cord Dysfunction Clinic Patients,” published July 1, 2025, in Ear, Nose & Throat Journal. 1 The authors’ comprehensive characterization of symptom patterns, comorbidities, and triggers among pediatric patients with inducible laryngeal obstruction (ILO) provides meaningful insight into the complexity of this condition. While the study found that 17.6% of patients reported anxiety, the authors acknowledged this may be an underrepresentation due to limitations in mental health assessment. This condition—traditionally known as vocal cord dysfunction (VCD), but increasingly described as ILO in recent literature—is often misdiagnosed as asthma or anxiety.
As a medical student, I have witnessed and studied how patients frequently cycle through subspecialists before receiving a VCD diagnosis. The use of structured tools—such as the Pittsburgh VCD Index or pediatric-specific questionnaires—may help clinicians identify these patients earlier, especially in general pediatric or pulmonary settings.
The role of speech-language pathologists in both diagnosis and therapy is another critical element underscored by the authors. As more children present with upper airway symptoms tied to maladaptive vocal patterns, emotional stress, or postviral inflammation, timely referral to trained speech-language pathologists becomes essential. Further research is warranted to determine which specific therapeutic strategies—such as behavioral retraining or breath control—yield the most sustained benefit in pediatric populations. Additionally, with adolescents increasingly exposed to health information on social media, it may be worthwhile to investigate how the digital landscape influences adolescents’ symptom perception, care-seeking behaviors, or self-diagnosis. Overall, I commend the authors for contributing meaningful data that will inform future multidisciplinary approaches to pediatric ILO and encourage continued refinement of care pathways for this underrecognized condition.
Sincerely,
Footnotes
Acknowledgements
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Ethical Considerations
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Data Availability
All data referenced in this article were obtained from publicly available sources. No new datasets were generated or analyzed during the current study.