Steroid inhaler laryngitis - Dysphonia caused by inhaled fluticasone therapy
Steroid inhaler laryngitis - Dysphonia caused by inhaled fluticasone therapy
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DOI：
10.1001/archotol.128.6.677
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发表时间：
2002-06-01
影响因子：
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通讯作者：
DelGaudio, JM
中科院分区：
文献类型：
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作者：
DelGaudio, JM
目的：描述一种被称为类固醇吸入器喉炎的疾病，一种由吸入丙酸氟替卡松引起的临床实体，表现为发音困难、清咽和饱胀。设计：病例系列。设置：一个学术转诊中心的门诊。患者：研究人群包括20例接受吸入性氟替卡松治疗的反应性气道疾病和发声困难患者，在1998年1月至2000年6月期间诊断为类固醇吸入器性喉炎。干预措施：在可能的情况下停止吸入氟替卡松治疗，以及治疗其他发声困难的潜在原因，如咽喉反流和感染过程。主要结果测量：停止吸入氟替卡松治疗后发声困难的解决。结果：类固醇吸入性喉炎患者的喉部表现从粘膜水肿、红斑、增厚到白斑、肉芽和念珠菌病。粘膜病变更严重的患者也更有可能出现咽喉返流。只有在停止吸入氟替卡松therapeutic.Conclusions：类固醇吸入器喉炎是一种形式的化学咽喉炎引起的局部类固醇给药。症状和体征与咽喉反流相似，但只有停止吸入性类固醇治疗才能完全缓解。耳鼻喉科医生应该熟悉发音困难的原因。
Objective: To describe a condition that is referred to as steroid inhaler laryngitis, a clinical entity that is caused by the use of inhaled fluticasone propionate and manifested by dysphonia, throat clearing, and fullness.Design: Case series.Setting: An outpatient clinic of an academic referral center.Patients: The study population consisted of 20 patients with reactive airway disease and dysphonia who were receiving inhaled fluticasone therapy and who were diagnosed as having steroid inhaler laryngitis during the period from January 1998 to June 2000.Intervention: Cessation of inhaled fluticasone therapy when possible, as well as treatment of other underlying causes of dysphonia, such as laryngopharyngeal reflux and infectious processes.Main Outcome Measure: The resolution of dysphonia with cessation of inhaled fluticasone therapy.Results: Patients with steroid inhaler laryngitis were found to have laryngeal findings ranging from mucosal edema, erythema, and thickening to leukoplakia, granulation, and candidiasis. Patients with more severe mucosal findings were more likely to have laryngopharyngeal reflux as well. Resolution of dysphonia occurred only after discontinuation of the inhaled fluticasone therapy.Conclusions: Steroid inhaler laryngitis is a form of chemical laryngopharyngitis induced by topical steroid administration. Symptoms and physical findings mimic laryngopharyngeal reflux, but only respond completely to discontinuation of the inhaled steroid therapy. The otolaryngologist should be familiar with this cause of dysphonia.