title: Dysphonia associated with the use of inhaled corticosteroids.
abstract: OBJECTIVE
  This article discusses the relationship between inhaled corticosteroids and dysphonia, with discussion of the therapeutic use of inhaled steroids in laryngeal disease and a review of negative laryngeal effects of this class of medication in patients with reactive airway disease.
  
  
  RESULTS
  Although prescribed for their anti-inflammatory effects (predominantly for pulmonary disease and less often for laryngeal conditions), corticosteroid inhalers can cause laryngeal inflammation. This may relate to chemical irritation from the inhaler itself as well as fungal inflammation related to opportunistic candidiasis that may accompany inhaler use. Patients who suffer from dysphonia because of inhaler use may improve if switched to another inhaler. Studies suggest that ciclesonide metered-dose inhaler may have less oropharyngeal deposition and therefore be associated with reduced oropharyngeal candidiasis and dysphonia compared with other inhaled corticosteroids.
  
  
  CONCLUSIONS
  Corticosteroid inhalers are a common cause of dysphonia and their use should be investigated in any patient with laryngeal complaints.
authors.affiliation: aDivision of Laryngology, Johns Hopkins Hospital bJohns Hopkins Voice Center cDepartment of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Chmielewska
authors.forename: Lee M
authors.initials: LM
authors.lastname: Akst
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D055154:Dysphonia / Q000139:chemically induced*; D006801:Humans; D009330:Nebulizers and Vaporizers
chemical_list: D000305:Adrenal Cortex Hormones