Is It Hot or Cold? Which Humid Air Is Better for Vocal Hygiene?

The purpose of this research is to determine which type of humid air should be suggested for vocal hygiene by demonstrating the effects of hot humid air and cold humid air on the vocal cord mucosa using different histological methods.

Randomized controlled study.

Cold or hot humid air was applied to the rats for 30 minutes/day for 10 days using a humid air machine placed in a closed glass cage. The control group did not receive any treatment and were kept in their cages under normal laboratory conditions. The animals were sacrificed and their larynxes were removed on the 11th day. Histologically, lamina propria (LP) thickness was measured by Crossman's three stain and the number of mast cells in 1 square millimeter of lamina propria was measured by toluidine blue. In immunohistochemical staining, the intensity of zonula occludens-1 (ZO-1) staining was measured using a rabbit polyclonal antibody and scored from 0 (no staining) to 3 (intense staining). One-way ANOVA and Kruskal-Wallis tests were used to compare groups.

The mean LP thickness was thinner in rats exposed to cold humid air (CHA) than in the control group (P = 0.012). In terms of LP thickness, other intergroup comparisons (cold vs hot and control vs hot) showed no statistically significant difference between groups (P > 0.05). The mean mast cell count did not differ between groups. The hot humid air (HHA) group had more intense ZO-1 staining than the other groups (P < 0.001). There was no difference in ZO-1 staining intensity between the control group and CHA group.

HHA and CHA administration had no negative effects on inflammatory findings in the vocal cords (mast cell count or LP thickness). While HHA appears to strengthen the epithelial barrier (denser ZO-1 staining), the physiologic outcomes, such as bronchoconstriction, should be cautiously assessed.