Role of steroids in acute phonotrauma: A basic science investigation

Area of Science:

• Laryngology
• Immunology
• Pharmacology

Background:

• Vocal fold inflammation is common in performers, often treated with steroids despite limited evidence.
• The impact of corticosteroids on the inflammatory profile of laryngeal secretions in phonotrauma is not well understood.

Purpose of the Study:

• To investigate the effects of oral hydrocortisone on laryngeal secretion cytokine profiles in a human phonotrauma model.
• To determine if corticosteroids modulate key inflammatory and healing cytokines following acute vocal fold injury.

Main Methods:

• A prospective, randomized, double-blinded, placebo-controlled trial involving 10 healthy females.
• Participants received oral hydrocortisone or placebo after experimental induction of acute vocal fold inflammation.
• Laryngeal secretions were analyzed for interleukin (IL)-1β, IL-6, and IL-10 levels at multiple time points.

Main Results:

• Steroid treatment significantly reduced levels of proinflammatory cytokines IL-1β and IL-6 compared to placebo.
• The anti-inflammatory cytokine IL-10 showed a marked increase in the hydrocortisone group, indicating immune modulation.
• These findings suggest a direct anti-inflammatory effect of corticosteroids on the vocal folds.

Conclusions:

• This study provides biological evidence supporting the efficacy of corticosteroids in managing acute vocal fold inflammation.
• The results support the clinical use of steroids for treating phonotrauma-induced laryngitis in vocal performers.
• Corticosteroids appear to exert their therapeutic effect by downregulating pro-inflammatory mediators and upregulating anti-inflammatory cytokines.