Corticosteroid-induced laryngeal disorders in asthma

Inhaled corticosteroids have proven to be the most effective agent available in treating bronchial asthma, and such treatment is believed to be very safe. Concerns regarding side effects of inhaled corticosteroids usually focus on potential systemic effects, where local side effects are often overlooked. The purpose of this study was to analyze and assess the influence of inhaled corticosteroids on the vocal cords of patients treated for bronchial asthma. Fifty patients (mean age: 50 years, range: 22 to 83 years) suffering from asthma and receiving corticosteroidal inhaled agents entered in this study. All of the patients underwent detailed videoscopic examination of the larynx. None complained of any laryngeal disorders or dysfunction before the diagnosis of asthma. All of the patients were non-smokers. Significant changes in the laryngeal status were observed. Changes included atrophy of laryngeal mucosa, vocal fold atrophy, and vocal fold bowing. Damage to the larynx is an important factor in patients with asthma treated with inhaled corticosteroids, which elicit apoptosis of the epithelium.