A short-term investigation of dysphonia in asthmatic patients using inhaled budesonide.
BACKGROUND
Dysphonia is one of the most common side effects of patients who use corticosteroid inhalers. The aim of this study was to investigate, prospectively, the occurrence of dysphonia in patients who used corticosteroid inhalers.


METHODS
Outpatients aged 18 years or older initially treated with inhaled corticosteroids were recruited. All patients were prescribed budesonide/formoterol. Questionnaires, perceptual studies, and acoustic analysis were performed five times during the study: at study entry and after 1, 4, 8, and 12 weeks. Videostroboscopy was performed at study entry and at 12 weeks. The data collected were analyzed by repeated-measures analysis of variance tests and Wilcoxon's signed rank test (P<0.01).


RESULTS
Sixty-two patients were enrolled and 29 patients (M:F=19:10) completed the study. Seven patients reported that they had problems with their voice; however, there were no statistically significant changes in the perceptual studies or the acoustic analysis. The videostroboscopy showed that "injection" and "increase of mucus" significantly increased by week 12. Vocal fold bowing was not noted in any of the patients.


CONCLUSIONS
The results of this study showed no significant voice changes in patients using corticosteroid inhalers over a period of 3 months. However, minor mucosal changes were found on videostroboscopy.
Kim
Han Su
HS
Department of Otolaryngology, Ewha Womans University School of Medicine, Seoul, Korea. sevent@ewha.ac.kr
Moon
Jin Wook
JW
Chung
Sung Min
SM
Lee
Ja Hyun
JH
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects*; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D004338:Drug Combinations; D055154:Dysphonia / Q000139:chemically induced* / Q000503:physiopathology; D004983:Ethanolamines / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D000068759:Formoterol Fumarate; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D049489:Stroboscopy; D011795:Surveys and Questionnaires; D013997:Time Factors; D014827:Vocal Cords / Q000187:drug effects / Q000503:physiopathology; D014831:Voice / Q000187:drug effects*; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D004338:Drug Combinations; D004983:Ethanolamines; D005938:Glucocorticoids; D019819:Budesonide; D000068759:Formoterol Fumarate