Voice Disorders Associated With the Use of Inhaled Corticosteroids

Objective: Inhaled corticosteroids (ICS) have been demonstrated to be associated with voice changes. The goal was to determine the strength of the association between ICS use and a diagnosis of dysphonia made by an otolaryngologist and to determine whether inhaler particle type or medication type influenced this risk. Study Design: A case-control study from 2018 to 2020. Setting: Urban academic medical system. Methods: Adult patients with dysphonia diagnosed by an otolaryngologist, and control patients matched on age, gender, race, and health status, were included. Exposure to ICS was assessed, and the odds ratio (OR) of the association of ICS with dysphonia was calculated. Results: A total of 6551 cases and 6551 matched controls were included. We found that ICS use was significantly associated with dysphonia (OR: 5.11, 95% confidence interval: 4.23-6.17, p <.001). Subset analyses demonstrated no significant differences between inhaler particle types or specific active medications. Conclusion: This study emphasizes the importance of identifying ICS use in the evaluation and treatment of patients with dysphonia.