The Effects of Three Nebulized Osmotic Agents in the Dry Larynx Purpose This investigation examined the effects of nebulized hypertonic saline, isotonic saline (IS), and sterile (hypotonic) water on phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) following a surface laryngeal dehydration challenge. Method In a double-blind, randomized experimental trial, 60 vocally healthy women (n = 15 per ... Research Article
Research Article  |   June 01, 2007
The Effects of Three Nebulized Osmotic Agents in the Dry Larynx
 
Author Affiliations & Notes
  • Kristine Tanner
    The University of Utah, Salt Lake City
  • Nelson Roy
    The University of Utah, Salt Lake City
  • Ray M. Merrill
    Brigham Young University, Provo, Utah
  • Mark Elstad
    George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, and University of Utah School of Medicine, Salt Lake City
  • Contact author: Kristine Tanner, Department of Communication Sciences and Disorders, University of Utah, 390 South 1530 East, Room 1201 BEH SCI, Salt Lake City, UT 84112-0252. E-mail: kristine.tanner@hsc.utah.edu.
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   June 01, 2007
The Effects of Three Nebulized Osmotic Agents in the Dry Larynx
Journal of Speech, Language, and Hearing Research, June 2007, Vol. 50, 635-646. doi:10.1044/1092-4388(2007/045)
History: Received February 2, 2006 , Revised May 5, 2006 , Accepted October 20, 2006
 
Journal of Speech, Language, and Hearing Research, June 2007, Vol. 50, 635-646. doi:10.1044/1092-4388(2007/045)
History: Received February 2, 2006; Revised May 5, 2006; Accepted October 20, 2006
Web of Science® Times Cited: 29

Purpose This investigation examined the effects of nebulized hypertonic saline, isotonic saline (IS), and sterile (hypotonic) water on phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) following a surface laryngeal dehydration challenge.

Method In a double-blind, randomized experimental trial, 60 vocally healthy women (n = 15 per group) underwent a laryngeal desiccation challenge involving oral breathing for 15 min using medical-grade dry air (RH<1%). Three of the four groups then received nebulized isotonic saline (0.9% NaCl), hypertonic saline (7% NaCl), or sterile (hypotonic) water, respectively; the 4th group served as a nontreatment control. PTP and PPE were estimated for high-pitched productions at baseline, immediately postdesiccation, and at 5, 20, 35, and 50 min postnebulization.

Results PTP increased significantly for all groups following the desiccation challenge. PTP values were, on average, 0.5 cm H2O greater immediately postdesiccation versus baseline. In contrast, PTP values did not change significantly following the administration of nebulized treatments, although a temporary trend toward a reduction in PTP was observed for the IS group. Unexpectedly, PPE ratings decreased significantly after the desiccation challenge. In general, PPE ratings were poorly correlated with PTP measures.

Conclusion A laryngeal desiccation challenge (i.e., temporary exposure to extremely low relative humidity while breathing transorally) significantly increased PTP. Although interesting trends emerged, none of the nebulized treatments significantly enhanced recovery from the negative effects of desiccation on PTP. In light of very low correlations between PTP and PPE, serious questions are raised regarding presumed associations between these measures.

Acknowledgments
We wish to thank Richard Lutz and John Moody for their assistance during the preparation of the experimental protocol for this investigation. We also acknowledge the work of university students Karen Straw, who assisted during data collection, and Jennifer Jackman, who helped with data reduction and analysis.
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