Dysphonia associated with inhaled steroids

The use of inhaled steroids in the treatment of asthma is not without its c omplications. In some studies up to 50% of such patients complain of oropha ryngeal and voice problems. We present the findings in 22 patients complain ing of dysphonia who underwent videostrobolaryngoscopy (VSL) and computeriz ed speech analysis. A number of abnormalities were identified. On VSL, thes e included mucosal changes (noted in 58%), apposition abnormalities (noted in 43%), and supraglottic hyperfunction (noted in 40%). On speech analysis, cycle-to-cycle irregularity was frequently noted (mean of 39%). Maximum ph onation time was reduced in 73%. Our findings did not confirm the widely he ld views that steroid dysphonia is due primarily to a fungal infection or a steroid-induced adductor myasthenia of the larynx. A larger-scale prospect ive study is indicated.