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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

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Practical considerations for dysphonia caused by inhaled corticosteroids.

César A Galván¹, Juan Carlos Guarderas

¹Clinical Immunology and Allergic Diseases Division, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú. cegals8@hotmail.com

Mayo Clinic Proceedings

|September 11, 2012

Summary

Inhaled corticosteroid (ICS) therapy can cause dysphonia, a voice disorder affecting 5% to 58% of asthma patients. Strategies like using spacers and rinsing the mouth can mitigate this side effect.

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Area of Science:

Pulmonology
Otolaryngology

Background:

Inhaled corticosteroid (ICS) therapy is a cornerstone for asthma management.
Dysphonia, or voice disorder, is a recognized local adverse effect of ICS, impacting a significant patient percentage (5%-58%).

Purpose of the Study:

To investigate the under-researched causes of dysphonia linked to ICS use.
To provide recommendations for managing and preventing ICS-induced dysphonia.

Main Methods:

Review of potential mechanisms for dysphonia development due to ICS deposition in the oropharynx.
Analysis of clinical recommendations for mitigating local side effects of inhaled medications.

Main Results:

Dysphonia may stem from direct ICS deposition in the oropharynx, leading to myopathy or mucosal changes in the laryngopharynx.
ICS use should be a consideration in the differential diagnosis of dysphonia.

Conclusions:

Implementing preventative measures such as using the lowest effective ICS dosage, employing spacers, and practicing post-inhalation hygiene (gargling, rinsing, face washing) is recommended.
If dysphonia persists despite interventions, temporary ICS cessation may be considered if asthma control is maintained.