Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment PurposeVoice problems are reported as a frequent side effect of inhaled combination (IC) treatments. The purpose of this experimental study was to investigate whether IC treatments are detrimental to phonation. We hypothesized that IC treatment would significantly increase phonation threshold pressure (PTP) and perceived phonatory effort (PPE), whereas sham treatment ... Article
Article  |   February 01, 2010
Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment
 
Author Affiliations & Notes
  • Elizabeth Erickson
    Purdue University, West Lafayette, IN
  • Mahalakshmi Sivasankar
    Purdue University, West Lafayette, IN
  • Contact author: Mahalakshmi Sivasankar, Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907. E-mail: msivasankar@purdue.edu.
Article Information
Speech, Voice & Prosody / Speech
Article   |   February 01, 2010
Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment
Journal of Speech, Language, and Hearing Research, February 2010, Vol. 53, 75-83. doi:10.1044/1092-4388(2009/09-0024)
History: Received February 7, 2009 , Accepted June 30, 2009
 
Journal of Speech, Language, and Hearing Research, February 2010, Vol. 53, 75-83. doi:10.1044/1092-4388(2009/09-0024)
History: Received February 7, 2009; Accepted June 30, 2009
Web of Science® Times Cited: 9

PurposeVoice problems are reported as a frequent side effect of inhaled combination (IC) treatments. The purpose of this experimental study was to investigate whether IC treatments are detrimental to phonation. We hypothesized that IC treatment would significantly increase phonation threshold pressure (PTP) and perceived phonatory effort (PPE), whereas sham treatment would not.

MethodFourteen healthy adults participated in a repeated-measures design in which they received IC and sham treatments in counterbalanced order. PTP and PPE were measured prior to treatments, immediately following treatments, and at 1 and 2 hr following treatments.

ResultsIC treatment increased PTP, but sham treatment did not. The increase in PTP was maintained for a 2 hr period following administration. PPE ratings were not significantly correlated with PTP.

ConclusionsIC treatments can have acute, adverse effects on phonation. Detrimental phonatory effects were elicited in participants with no self-reported voice problems. IC treatments are being increasingly prescribed across the lifespan. The current data increase our understanding of the nature of phonatory deterioration associated with IC treatment and lay the groundwork for increased research effort to develop IC treatments that effectively control respiratory disease while minimizing an adverse effect on phonation.

Acknowledgments
This work was supported, in part, by the Indiana Lions Club McKinney Outreach Research Award. This work is based on a thesis by the first author, submitted in partial fulfillment of the requirements for the master of science degree from the Department of Speech, Language, and Hearing Sciences at Purdue University. We acknowledge the valuable insights provided by Jessica Huber, Christine Weber-Fox, and Barbara Solomon throughout this project. We also thank Daniel Berner and Robert Stephens for their assistance with videostroboscopic interpretation. We appreciate the contributions of Breanna Stevens, Johanna Hassink, and Mira Stankovich to reliability analysis. GlaxoSmithKline provided the empty Advair diskus® shells used in this study.
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