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Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment

Address for correspondence: Mahalakshmi Sivasankar, Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, E-mail: msivasankar{at}purdue.edu, Phone: (765) 496 6628, Fax: (765) 494 0771

Purpose: Voice problems are reportedly a frequent side-effect of inhaled combination (IC) treatments. The purpose of this experimental study was to investigate whether IC treatments are detrimental to phonation. We hypothesized that IC but not sham treatment would significantly increase phonation threshold pressure (PTP) and perceived phonatory effort (PPE).

Methods: Fourteen healthy adults participated in a repeated-measures design over two experimental days where they received IC and sham treatments in counterbalanced order. PTP and PPE were collected prior to, and immediately, 1-hour, and 2-hours following IC and sham treatment.

Results: IC but not sham treatment increased PTP. The increase in PTP was maintained for 2-hours following administration. PPE ratings were not significantly correlated with PTP.

Conclusions: IC treatments can have acute, adverse effects on phonation. Detrimental phonatory effects were elicited in participants with no self-reported voice problems. IC treatments are being increasingly prescribed across the lifespan. The current data increase our understanding of the nature of phonatory deterioration associated with IC treatment, and lay the groundwork for increased research effort to develop IC treatments that effectively control respiratory disease while minimizing an effect on phonation.

KEY WORDS: inhaled combination treatments, corticosteroids, beta-agonists, voice problems

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