+ 65 6710 7522
Steroid Inhaler Laryngitis
Steroid inhalers are used commonly for the treatment of asthma. Doctors unfortunately do not spend time explaining to patients how to use these inhalers. There are also many patients who have been prescribed long-term inhaled steroids for chronic coughing. These patients may not need inhaled steroid therapy. Needless to say, you should consult your doctor before you stop any inhaler.
I recently saw two patients who had been given steroid inhalers for presumed asthma. Soon after commencing inhaler therapy, they developed a sore throat and hoarseness. These patients had not been told to rinse their mouth and gargle with water after application of the inhaler. The first patient had a good going yeast infection of the voicebox. This is known as laryngeal candidiasis (see picture below). Notice the white spots on the posterior pharyngeal wall and vocal cords.
The second patient had a chronic cough following a lower respiratory tract infection. Her chest x-ray had shown a right lower lobe pneumonia. Despite the coughing, her voice was unchanged until she was prescribed an inhaler by a respiratory physician. She had seen another ENT surgeon who had diagnosed reflux, but her stroboscopic examination showed laryngitis with early vocal fold nodules. The literature on steroid-inhaler laryngitis suggests that many of these patients are often diagnosed with laryngopharyngeal reflux (LPR). Treatment with proton-pump inhibitors and antacids often provide no benefit.
If you are an asthmatic on a steroid inhaler, do spend a few minutes watching these excellent videos on Asthma UK’s website https://www.asthma.org.uk/advice/inhaler-videos/#Videos
Share this blog via:
