title: Nebulized isotonic saline versus water following a laryngeal desiccation challenge in classically trained sopranos.
abstract: OBJECTIVE
  To examine the effects of nebulized isotonic saline (IS) versus sterile water (SW) on self-perceived phonatory effort (PPE) and phonation threshold pressure (PTP) following a surface laryngeal dehydration challenge in classically trained sopranos.
  
  
  METHODS
  In a double-blind, within-subject crossover design, 34 sopranos breathed dry air (relative humidity < 1%) transorally for 15 min and then nebulized 3 mL of IS or SW, or experienced a no-treatment control condition over 3 consecutive weeks. PPE and PTP were measured every 15 min from baseline through 2 hr postdesiccation.
  
  
  RESULTS
  PPE increased significantly following the laryngeal desiccation challenge in all 3 treatment conditions (p < .01). After nebulization, PPE returned to baseline for the IS condition only. For the SW and control conditions, PPE remained above baseline during the 2 hr after desiccation. No statistically significant changes in PTP following laryngeal desiccation were observed, although values for the IS condition remained below baseline for nearly 2 hr after nebulization. PPE and PTP were not significantly correlated.
  
  
  CONCLUSIONS
  Following a laryngeal surface dehydration challenge, classically trained sopranos reported increased vocal effort that persisted for at least 2 hr. Compared with SW, nebulized IS showed promise as an effective way to remediate the adverse, self-perceived effects of laryngeal desiccation.
authors.affiliation: Department of Communication Sciences and Disorders, Division of Otolaryngology-Head & Neck Surgery, The University of Utah, Salt Lake City, UT 84112, USA. kristine.tanner@hsc.utah.edu
authors.forename: Kristine
authors.initials: K
authors.lastname: Tanner
authors.forename: Nelson
authors.initials: N
authors.lastname: Roy
authors.forename: Ray M
authors.initials: RM
authors.lastname: Merrill
authors.forename: Faye
authors.initials: F
authors.lastname: Muntz
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Houtz
authors.forename: Cara
authors.initials: C
authors.lastname: Sauder
authors.forename: Mark
authors.initials: M
authors.lastname: Elstad
authors.forename: Julie
authors.initials: J
authors.lastname: Wright-Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006813:Humidity; D007552:Isotonic Solutions / Q000008:administration & dosage; D007818:Laryngeal Diseases / Q000628:therapy*; D008875:Middle Aged; D009146:Music; D009330:Nebulizers and Vaporizers; D009784:Occupational Diseases / Q000628:therapy; D010699:Phonation; D012965:Sodium Chloride / Q000008:administration & dosage*; D014833:Voice Quality; D014867:Water / Q000008:administration & dosage*; D014987:Xerostomia / Q000628:therapy*; D055815:Young Adult
chemical_list: D007552:Isotonic Solutions; D014867:Water; D012965:Sodium Chloride