İnhaler kortikosteroid kullanan astım hastalarında ses değerlendirmesi

Amaç: Bu çalışmada inhaler kortikosteroid kullanan astım hastalarında ses değişiklikleri ve larenks anormallikleri değerlendirildi.Hastalar ve Yöntemler: Bu çalışmaya Mayıs 2013 - Aralık 2013 tarihleri arasında İKS ile tedavi edilen bronşiyal astımlı 30 hasta 15 kadın; ort. yaş 21.3±2.6 yıl; dağılım, 17-26 yıl ve 15 erkek; ort. yaş 20.7±2.3 yıl; dağılım 16-27 yıl alındı. Her hastanın konuşma örneği iki foniatrist tarafından değerlendirildi ve disfoni dereceleri skorlandı. Her hastanın sesi çok boyutlu ses programı yazılımı ile akustik olarak analiz edildi. Ses telleri dahil larenks anormalliklerini tespit etmek amacıyla videolarengoskopi kullanıldı. Bulgular: İnhaler kortikosteroid İKS kullananların toplam %53.3’ünde disfoni vardı, bunların çoğunda disfoni derecesi hafifti. Hastaların %56.7’sinde ses tellerinde eritem, %56.7’sinde interaritenoid kalınlaşma, %5.3’ünde ses tellerinde sarkma ve %5.5’inde ses tellerinde atrofi vardı. Hastaların toplam 36.7’sinde larengofarengeal reflü bulgusu vardı. Ses tellerinde sarkma ve atrofi, anlamlı olarak İKS kullanım süresi ile ilişkilendirildi p=0.048 . Yumuşak fonasyon indeks değerleri, İKS kullanım süresi ile pozitif olarak ilişkiliydi p=0.013 .Sonuç: İnhaler kortikosteroidler ses tellerinin hem fonksiyonu hem de yapısı üzerinde anormal advers etkiye sahiptir

Voice evaluation in asthma patients using inhaled corticosteroids

Objectives: This study aims to assess voice changes and laryngeal abnormalities in asthmatic patients using inhaled corticosteroids ICSs . Patients and Methods: This study included 30 patients 15 females; mean age 21.3±2.6 years; range, 17 to 26 years and 15 males; mean age 20.7±2.3 years; range, 16 to 27 years with bronchial asthma treated with ICSs between May 2013 and December 2013. A speech sample from each patient was evaluated by two phoniatricians and the degrees of dysphonia were scored. Each patient’s voice was acoustically analyzed using the multidimensional voice program software. Videolaryngoscopy was used to detect laryngeal abnormalities including the vocal folds. Results: A total of 53.3% of ICSs users had dysphonia; most of them had a mild degree dysphonia. Of patients, vocal folds erythema was present in 56.7%, interarytenoid thickening in 56.7%, vocal folds bowing in 5.3% and vocal fold atrophy in 5.5%. A total of 36.7% patients had manifestations of laryngopharyngeal reflux. The presence of vocal fold bowing and atrophy was significantly related to the duration of ICS use p=0.048 . Soft phonation index values were positively associated with the duration of the ICS use p=0.013 . Conclusion: Inhaled corticosteroids have abnormally adverse effects both on the function and the structure of the vocal folds.

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