Use of inhaled versus oral steroids for acute dysphonia

Souza, Andrea Moreira Veiga de; Duprat, André de Campos; Costa, Rejane Cardoso; Pimenta, Janaína de Oliveira; Andrade, Fernanda Fonseca de Sá; Silva, Fernanda Ferreira da

doi:10.5935/1808-8694.20130035

Cited by 11 publications

(2 citation statements)

References 23 publications

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“…Hanania et al, 16 reported that these findings could be explained by the irritation of the laryngeal mucosa or by deposits from the inhalation of steroids. These results were similar to the findings of Souza et al, 17 who showed that voice pathology associated with ICS can cause increased noise components in the voice signal such as fundamental frequency, turbulent noise, and voice breaks. Roland et al, 18 in their study on the impact of ICS on voice, found an increased incidence of frequency and amplitude perturbation values (jitter and shimmer) in patients who received ICS in high doses and for a long duration.…”

Section: Discussionsupporting

confidence: 91%

Voice changes associated with inhaled steroids 1n obstructive lung disease patients

Baraka¹,

El-Dessouky²,

Khamees³

et al. 2020

JOENTR

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Background/Aims: The widespread use of inhaled corticosteroids (ICS) for the treatment of obstructive lung disease may be associated with both systemic and local side effects. These local side effects; including voice problems, oropharyngeal candidiasis, throat clearing, sense of fullness, pharyngitis, and cough, are generally viewed as minor complications of therapy in what is called steroid inhaler laryngitis (SIL). Few studies have been performed to specifically evaluate local side effects of ICS. However, they can be clinically significant, affect patient's quality of life, hinder compliance with therapy, and mask symptoms of more serious disease. The aim of this study is to examine the effect of ICS on the larynx and subsequent voice changes, and highlighting if these voice problems related to the type of inhaled corticosteroids in order to determine the importance of regular laryngeal examination in those patients. Methods: 40patients with bronchial asthma and 40 patients with COPD admitted to Chest department in Menoufia and Zagazig University Hospitals during the period from March 2017 to March 2019 were included in the study. They were divided according to the type of cortisone used into four groups; group (I): beclomethasone dipropionate (BDP) users, group (II): budesonide (BUD) users, group (III): Ciclesonide users and group (IV): fluticasone propionate (FP) users. They were evaluated as regards videolaryngoscopic examination and acoustic analysis Results: The age of the patients with bronchial asthma ranged from 29 to 42years and the age of the patients with COPD ranged from 31 to 43years. There was a statistically significant difference among the four groups of cortisone inhalation regarding laryngoscopic findings; as presence of congestion (diffuse and local), mucus spills on VF and glottis gap were all higher in frequency among the group of patients used fluticasone FP, while least signs found among ciclesonide users. Also, average pitch, Jitter, H/N ratio and MPT were more worsen in fluticasone group when compared with Ciclesonide group. Conclusion: obstructive lung disease patients may suffer from voice problems related to the type of inhaled corticosteroids that could be fade when therapy is stopped. So, regular laryngeal examination in those patients is important.

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Section: Discussionsupporting

confidence: 91%

Voice changes associated with inhaled steroids 1n obstructive lung disease patients

Baraka¹,

El-Dessouky²,

Khamees³

et al. 2020

JOENTR

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“…A prospective cohort study of 32 adult patients with acute dysphonia caused by laryngitis evaluated the effectiveness of treatment with inhaled fluticasone 50 mcg twice a day or oral prednisone 20 mg twice a day for seven days. 1 No control group was present in this study. Researcher excluded patients who smoked, had mental disorders, had physiological and motor problems, or had laryngeal structural disorders.…”

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confidence: 89%

Do steroids help reduce symptoms of laryngitis (ie, vocal recovery)?

Hungenberg,

Rincon,

Houss

et al. 2023

EBPR

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A 2009 open-label RCT (n5135) compared the efficacy of transdermal buprenorphine and sustained-release tramadol. 2 Patients had a mean age of 64 years old, with 57% female and 99% White. Patients were included if they had a clinical and radiological diagnosis of osteoarthritis of the hip or knee, no use of high-potency opioid analgesics for greater than one week in the previous three months, and moderate-to-severe pain defined as $4 on an 11point box scale (BS-11, ranging from 0 [no pain] to 10 [worst pain]). During the one-week screening phase, patients discontinued any current analgesia treatment and took four grams of acetaminophen daily. At the end of one week, patients were randomized in a 1:1 ratio to receive transdermal buprenorphine (n569; maximum dosage of 20 mcg/hour) or sustained-release tramadol (n566; maximum dosage of 400 mg/day), titrated as needed for adequate pain control. During the 12-week treatment phase, patients were permitted to take up to two grams of acetaminophen per day for rescue pain management. Patients recorded pain scores daily in a diary and the average weekly BS-11 score was the primary efficacy endpoint (prespecified noninferiority margin of 61.5). The secondary efficacy endpoint was use of rescue acetaminophen as recorded by patients. No significant difference was noted in the least squares mean change in BS-11 scores from baseline to study completion between the two groups (buprenorphine -2.26 vs tramadol -2.09; P value not provided). No significant difference was also noted in the mean number of rescue acetaminophen tablets used (buprenorphine 206 vs tramadol, 204; P value not provided). The most common adverse effects in both groups included nausea, abdominal pain, chest pain, and subendocardial myocardial infarction. This study was limited by noninferiority and open-label design.

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