[Multifactorial genesis of chronic laryngitis - impact of inhaled corticosteroids]

Inhaled corticosteroids (ICS) are used as guideline-based therapy for bronchial asthma as well as chronic obstructive pulmonary disease (COPD). Adverse effects of this drug therapy include oropharyngeal and laryngeal candidiasis and chronic laryngitis. As a prodrug, the inhaled corticosteroid ciclesonide exerts its active effect in the lungs. Reduction of oropharyngeal candidiasis has already been described under ciclesonide and a possible positive effect on laryngeal mucosa should now be tested.Videolaryngoscopic and -stroboscopic recordings and voice analyses were retrospectively assessed after ICS conversion. The control groups included patients who had not switched or had discontinued their ICS.Statistical analysis showed that all three patient groups showed a trend toward improvement in laryngeal function and findings between initial diagnosis and follow-up. The results were not of statistical significance.The causes of chronic laryngitis are often multifactorial (smoking, ICS, reflux, diabetes). Switching ICS to ciclesonide is one aspect of the therapy for chronic laryngitis; its use instead of another ICS to treat pulmonary diseases seems to reduce adverse laryngeal effects. Even comprehensive specialist advice and guidance on mucosal hygiene appear to have a positive therapeutic effect.