Influence of Inhaled Drugs on Multidimensional Voice Quality of Asthma Patients: A Controlled Study.

Abstract

Objective: To investigate the voice quality in asthma patients treated with inhaled drugs (ID) through multidimensional voice quality assessment.

Methods: Consecutive patients with well-controlled asthma treated with ID were prospectively recruited from the otolaryngology offices of two private practice settings from August 2024 to April 2025. A control group of patients without ID treatment was composed of patients without ear, nose, and throat disorders. The voice quality of patients and controls was evaluated with the Voice Handicap Index (VHI), blinded perceptual GRBASI evaluation, maximum phonation time (MPT), and acoustic measurements. Laryngopharyngitis symptoms and findings were evaluated with the Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA). Laryngopharyngeal, nose, and eye dryness was evaluated with the total rating of eye, nasal, and dry-mouth (TREND) assessment.

Results: Thirty asthma patients with an inhaled corticosteroid treatment and 50 controls completed the evaluation. Asthma patients reported significantly higher VHI, GRBASI, RSS, and RSA compared to controls. MPT was significantly lower in asthmatics compared to controls. F0 standard deviation and percent shimmer were significantly higher in asthmatics versus controls. Grade of dysphonia and breathiness were significantly correlated with STD and percent shimmer.

Conclusion: ID users demonstrated impaired multidimensional subjective and objective voice quality evaluations compared to controls. Future controlled mechanistic studies are needed to better understand to relationship between ID and vocal fold function impairments.