Presentations

Abstract

Introduction: Inhaled Corticosteroids (ICS) are widely used therapeutics, commonly used for disorders such as asthma, chronic obstructive pulmonary disease (COPD), and vocal process granulomas. Side effects seen in users of ICS include dysphonia, chronic cough, sore throat, odynophagia, and dysphagia. One of the most commonly reported side effect is dysphonia, with up to 58% of users reporting a change in voice. These unwanted effects may be caused by fungal laryngitis. The actual rate of fungal laryngitis in ICS users is unclear, with values ranging from 0 - 77% in current literature. Reasons for this lack of clarity include subtle and variable findings on exam, lack of existing information associating fungal laryngitis and laryngoscope findings, empiric treatment, and lack of referrals for laryngoscopy.

Methods: In order to determine within ICS users, the true prevalence and laryngeal features of fungal laryngitis, a prospective observational cohort study aimed to recruit 50 subjects with 5 controls. Patients using a regiment of daily ICS for at least a month, were recruited from the Sentara Pulmonary Specialists and screened using inclusion & exclusion criteria. Identified subjects visited the EVMS Otolaryngology Clinic for single in-office visit and completed questionnaires (including the voice handicap index (VHI)), a fungal culture, and a scope exam.

Results: From May 2024 to July 2024, 30 patients meeting the ICS criteria were screened, 8 consented, and 1 completed their in-office visit.

Conclusion: Recruitment and completion of in-office visits will continue in 2024 until the recruitment goal of 50 patients is achieved. Information collected through the questionnaires and laryngoscopy will be reviewed and evaluated. The association between these findings and those seen with culture data will help establish an informative framework for diagnosing and establishing prevalence of fungal laryngitis in ICS users.