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At least 109 records · Page 6Linked to original sources

Serial anatomy of the larynx in MRI: MRI-histologic correlations.

The larynx is an organ with a complex anatomic structure. MRI allows the performance of sections in the three planes of space, so that this study of the soft parts of the larynx yields results superior to those of other imaging techniques. Together with laryngoscopy, MRI is most often used in assessing the extension of malignant laryngeal tumors. This assessment is fundamental in choosing the indications for surgery, but the published reports of MRI of the larynx are sometimes discordant. The visualization of certain important anatomic structures such as the conus elasticus is uncertain. Our aim was to study the MRI radio-anatomy of the larynx based on correlations between MRI and histologic sections. Eight anatomic specimens were studied: four in the transverse plane, two in the sagittal plane, and two in the frontal plane. The MRI and histologic sections made at the same levels were compared. These comparisons allowed a description of the sectional radio-anatomy of the larynx and an assessment of the reliability and limitations of MRI. All the major anatomic structures could be identified. It was possible to demonstrate the conus elasticus. We were able to visualize the vocal process of the arytenoid cartilage, which has not to our knowledge been previously described in the literature.

Aged↗

External trauma to the larynx: classification, diagnosis, therapy.

In contrast to internal trauma to the larynx caused by endolaryngeal procedures, trauma to the larynx caused by external forces is relatively rare. Nevertheless, the great variety of these external traumata warrants a thorough diagnosis and understanding of each case as well as a standardized and accepted method for classifying these injuries. These preconditions will facilitate successful therapy. At our three institutions cases of external trauma to the larynx, including the mechanisms of trauma, were reviewed and analyzed. Cases were classified according to the mechanisms and the sequelae of trauma. The three major categories were (a) external trauma due to the impact of blunt objects, (b) trauma after tearing of the neck and the larynx longitudinally, and (c) external trauma caused by sharp objects and gunshots. In the great majority of cases external trauma to the larynx was caused by blunt pressure and was most often due to strangulation in the course of (attempted) suicide or homicide. In a smaller number of cases sharp instruments caused external traumata. In patients surviving the immediate trauma a meticulous laryngological assessment is necessary. In addition to indirect laryngoscopy, we consider microlaryngoscopy as being indicated for investigating the soft tissues of the endolarynx. The status of the laryngeal skeleton can be determined more precisely via high-resolution computed tomography and ultrasound. Early diagnosis and appropriate therapy have a significant impact on the patient's condition later, especially as regards scar formation, ease of breathing, and voice quality.

Humans↗

[Occurrence of non-metaplastic squamous epithelium within the larynx and its relation to the development of cancer].

The study is concerned with the occurrence and distribution of squamous epithelial areas in the human larynx as well as with the question as to whether inferences with regard to the development of inner laryngeal carcinomas can be made from their location. For this purpose, macroscopic epithelial staining was carried out on 104 cadaver larynxes and the results compared with the tumor location established in macroscopic serial sections of approximately 100 surgical preparations of extirpated larynxes. Special interest was devoted above all to the occurrence of squamous epithelium outside the vocal cord level. The authors found special sites of predilection for carcinogenesis which showed an astonishingly striking correlation with the distribution of the squamous epithelium found in the interior of the larynx in all age groups. Direct carcinogenesis from healthy squamous epithelium is discussed as well as the development of cancer from a metaplastic transformation of ciliated epithelium into squamous epithelium. The results constitute a contribution to early diagnosis of inner tumors of the larynx, since on the basis of the results it appears to be indicated that increased specific attention needs to be paid to the parts of the mucosa which display areas of squamous epithelium with a certain regularity in microlaryngoscopy.

Adolescent↗

Oxidative DNA base modifications and polycyclic aromatic hydrocarbon DNA adducts in squamous cell carcinoma of larynx.

Tobacco smoke, recognized as a major etiological factor for cancers of the upper aerodigestive tract, represents an abundant source of reactive oxygen species (ROS), which are believed to play a significant role in mutagenesis and carcinogenesis. An additional source of ROS in tissues exposed to tobacco smoke may be metabolic oxidation of polycyclic aromatic hydrocarbons (PAH). To investigate the relationships between oxidative DNA lesions and aromatic DNA adducts, six modified DNA bases 5-hydroxyuracil, 5-hydroxycytosine, 7,8-dihydro-8-oxoguanine, 7,8-dihydro-8-oxoadenine, 2,6-diamino-4-hydroxy-5-formamidopyrimidine and 4,6-diamino-5-formamidopyrimidine and the total level of PAH-related DNA adducts were measured in cancerous and the surrounding normal larynx tissues (68 subjects), using gas chromatography/isotope-dilution mass spectroscopy with selected ion monitoring and the 32P-postlabeling-HPLC assay, respectively. The levels of oxidative DNA lesions in cancerous and adjacent tissue were comparable; the differences between the two types of tissue were significant only for 5-hydroxypyrimidines (slightly higher levels were observed in the adjacent tissue). Comparable levels of DNA lesions in cancerous and the surrounding normal tissues observed in the larynx tumors support a field cancerization theory. The surrounding tissues may still be recognized as normal by histological criteria. However, molecular alterations resulting from the chronic tobacco smoke exposure, which equally affects larynx epithelia, may lead to multiple premalignant lesions. Thus, a demonstration of similar levels of DNA damage in cancerous and the adjacent tissue could explain a frequent formation of secondary tumors in the larynx and the frequent recurrence in this type of cancer. A weak, but distinct effect of tumor grading and metastatic status was observed in both kinds of tissue in the case of 5-hydroxyuracil, 5-hydroxycytosine, 7,8-dihydro-8-oxoguanine, 7,8-dihydro-8-oxoadenine. This effect was displayed as a gradual shift in the data distribution toward high values from G1 through G2-G3 and from non-metastatic to metastatic tumors. Since the levels of oxidative DNA base modifications tended to increase with the tumor aggressiveness, we postulate that the oxidative DNA lesions increase genetic instability and thus contribute to tumor progression in laryngeal cancer. No associations between aromatic adduct levels and oxidative DNA lesions were present, suggesting that the metabolism of PAH does not contribute significantly to the oxidative stress in larynx tissues, remaining the tobacco smoke ROS as a major source of oxidative DNA damage in the exposed tissue.

Adult↗

Assessing neuromuscular block at the larynx: the effect of change in resting cuff pressure and a comparison with video imaging in anesthetized humans.

UNLABELLED: Neuromuscular block (NMB) at the larynx has been assessed by measuring the cuff pressure (CP) in an endotracheal tube (ETT) placed between the vocal cords. In this study, we evaluated the decrease in resting cuff pressure (RCP) after the administration of rocuronium and the effect of this decrease on the assessment of NMB, and we compared CP measurement with an alternative technique, video imaging (VI). In 20 patients, NMB was determined at the hand by mechanomyography and at the larynx initially by CP and subsequently by VI, recording images using a fiberoptic bronchoscope via a laryngeal mask. Train-of-four stimuli were applied at both sites. After baseline measurements, the ETT was replaced, and rocuronium was infused to achieve a steady-state 50% (n = 10) or 75% (n = 10) block at the hand. CP measurements were recorded before and after restoration of RCP to prerocuronium pressure, followed by further VI measurements. The mean RCP decreased from 21 +/- 4 to 12 +/- 5 mm Hg after rocuronium. At 50% block at the hand, the CP estimate of block at the larynx with reduced RCP was 62% +/- 18%, and that after restoring RCP was 29% +/- 13%; VI estimated 27% +/- 14% block. At 75% block at the hand, CP and VI estimated 52% +/- 11% and 46% +/- 9% block, respectively (RCP maintained). We conclude that RCP decreases after the administration of rocuronium, that restoring RCP significantly alters CP estimates of NMB, and that VI is in agreement with CP measurement if RCP is maintained at prerelaxant values. IMPLICATIONS: In this study, we show that a muscle relaxant-induced decrease in resting tension at the larynx may confound the assessment of neuromuscular block by cuff pressure measurement. The preliminary data suggest that video imaging may provide a suitable alternative to cuff pressure measurement to assess neuromuscular block at the larynx.

Adult↗

A preclinical model for laryngeal transplantation: anatomy and mucosal immunology of the porcine larynx.

BACKGROUND: A major step in translating work on laryngeal transplantation into clinical practice is the establishment of a preclinical model. We have investigated the anatomy and mucosal immunology of the porcine larynx in eight Minnesota Minipigs (12-37 weeks). METHODS: Neck dissections were carried out and the vascular tree was mapped. Snap-frozen biopsies from epiglottis, supraglottis, glottis, and subglottis were prepared for conventional histology, immunohistochemistry (CD45), and single and two-color immunofluorescence (CD3, MHC-II, CD45). RESULTS: The anatomy of the laryngeal skeleton was broadly similar to that of the human larynx. The blood supply is predominantly via the caudal thyroid vessels, with assistance from the cranial laryngeal artery. The porcine larynx is clearly highly immunologically active. Structured collections of leukocytes were found in the mucosal epithelium, around tubuloacinar glands, and occasionally in the submucosa. MHC-II and CD 3 cells were predominantly found within the epithelium. The highest densities of all cell types were observed in the epiglottis, tailing off caudally. The lowest densities were seen in the vocal cords. CONCLUSIONS: The porcine larynx is both anatomically and immunologically similar to the human larynx and contains a high level of immunological organization. It presents an ideal preclinical model for laryngeal transplantation.

Animals↗

The larynx as an immunological organ: immunological architecture in the pig as a large animal model.

The larynx is a mucosal organ positioned at the divergence of the respiratory and digestive tracts. It is exposed to a wide variety of environmental components, including foreign antigens, tobacco smoke, laryngopharyngeal reflux and pollutants. The mucosal immune system generates either active immune responses or tolerance, depending on the nature of the antigen and we hypothesize that the larynx is important organ for immunological decision-making in the airway. Because the pig is an ideal large animal model in which to explore laryngological research questions, such as those relating to laryngeal transplantation, we investigated the normal mucosal immunology of the porcine larynx. Pig larynges and tracheae were processed and prepared for bright-field microscopy and quantitative, multiple-colour immunofluorescence histology using pig-specific monoclonal antibodies. There was an abundance of immunologically active cells within the mucosa of the larynx and trachea of both the newborn and adult animal. Specifically, major histocompatibility complex class II (MHC class II+) cells, CD4+ and CD8+ cells were identified, although regional differences in numbers were apparent: specifically, the supraglottis contained fewer immunologically relevant cells than other sites sampled. There was a significant correlation between the numbers of MHC class II+ and CD4+ cells indicating co-ordinate regulation and therefore functional local interactions. The presence of such an immunological structure suggests that the larynx may have important functions in respiratory immunology and that it may trigger strong alloresponses after laryngeal transplantation.

Animals↗

Comparison of the neuromuscular blocking effect of cisatracurium and atracurium on the larynx and the adductor pollicis.

BACKGROUND: Cisatracurium unlike atracurium is devoid of histamine-induced cardiovascular effects and this alone would be the greatest advantage in replacing atracurium for the facilitation of tracheal intubation. On the other hand, 2 ED(95) doses of cisatracurium (100 micro g/kg) do not yield satisfactory intubating conditions such as those seen with equipotent doses of atracurium and therefore the recommended intubating dose of cisatracurium is 3 ED(95). To understand this discrepancy better, we evaluated the potency and onset of atracurium and cisatracurium directly at the larynx adductors in humans. METHODS: The study was conducted in 54 patients (ASA class I or II) undergoing peripheral surgery requiring general anesthesia. Cisatracurium 25-150 micro g/kg or atracurium 120-500 micro g/kg intravenous (i.v.) boluses doses were administered during anesthesia with propofol, nitrous oxide, oxygen and fentanyl. Neuromuscular block was measured by electromyography (single twitch stimulation every 10 s) at the larynx and the adductor pollicis. The dose-response effect measured at both muscles included maximum neuromuscular blockade achieved (Emax), the time to maximum depression of twitch height (onset) and time to spontaneous recovery of the twitch height to 25%, 75% and 90% (T25, T75, T90) of control value. RESULT: The onset at the larynx was of 196 +/- 28 s after the 100 micro g/kg cisatracurium dose compared with 140 +/- 14 s after the 500 micro g/kg atracurium dose (P < 0.05). Emax at the larynx was 92 +/- 1% and 98 +/- 1% after 100 micro g/kg cisatracurium and 500 micro g/kg atracurium, respectively (P < 0.05). The time to onset of maximum suppression Emax = 100 +/- 0% after a 150 micro g/kg cisatracurium dose was 148 +/- 29 s. At the larynx, the ED(50) was 25 micro g/kg for cisatracurium and 180 micro g/kg for atracurium and the ED(95) was 87 micro g/kg for cisatracurium compared with 400 micro g/kg for atracurium. CONCLUSION: The slow onset time at the laryngeal muscles after cisatracurium can be explained by the higher potency as compared with atracurium.

Adult↗

Measuring larynx movement in standard Thia using the cricothyrometer.

Vertical movement of the larynx during connected speech was investigated in Standard Thai - a language that has five phonologically contrastive tones. The effects of pitch, consonant phonation-type, vowel quality, tonal categories, and position in the utterance were determined. Utterance position was found to be the factor most clearly associated with variations in larynx movement. The occurrence of an overall rise-fall pattern of larynx movement distributed over utterances of varying pitch patterns leads to the conclusion that larynx height is not a principal factor regulating pitch in connected speech. Implications for models of pitch production, distinctive features for tone, theories on the historical development of tone and the role of larynx movements in the production of consonants and vowels are discussed.

Adult↗

Morphology of the human larynx during the first five years of life studied on whole organ serial sections.

The morphologic development of the human larynx during the first years of life is poorly understood to date. This study used plastinated whole organ serial sections to determine the growth and structure of the infant larynx. The larynges of 43 children 1 to 60 months old were plastinated. Whole organ serial sections were obtained by cutting the resulting specimen with a diamond band saw. The slices were then submitted to computer-assisted morphometric investigation. We found that the subglottic airway rapidly increases in size during the first 2 years of life. Further growth follows a linear mode. The relative proportion of the mucosal lining decreases likewise. In contrast to that in adults, and comparable to that in most mammals, the cartilaginous glottis accounts for 60% to 75% of the vocal folds' length at <2 years. No sexual dimorphism of the larynx exists during childhood. This study supplies detailed morphometric data on the growth and structure of the human larynx during the first years of life. It is the first to use plastinated whole organ serial sections for morphology of the pediatric larynx. Therefore, this study provides quantitative anatomic data of clinical interest that have not been available to date.

Child, Preschool↗

The IPA categories "pharyngeal" and "epiglottal": laryngoscopic observations of pharyngeal articulations and larynx height.

The phonetic problem is to describe accurately the articulatory mechanism, or mechanisms, responsible for the production of a series of sounds that are presently labelled on the chart of the International Phonetic Association as either pharyngeal or epiglottal. The sounds on which these categories are based are found in the Semitic languages, in the languages of the Caucasus, and in the languages of the Pacific Northwest coast of North America. In order to reconcile a variety of descriptive terms with a logical phonetic taxonomy, auditorily distinguishable parameters are deduced from a naturally occurring variety of sounds, isolated articulatorily, and observed with a fibreoptic laryngoscope to define a cardinal set of articulatory possibilities. Auditory comparisons with database illustrations of the sounds of various languages inform the production of cardinal values in the laryngoscopic study. Voiceless pharyngeals (fricatives) are identified by aryepiglottic fold constriction and a medial aperture. Voiced pharyngeals (approximants) are identified by aryepiglottic fold constriction and a covered glottis. Trilling can occur laterally along the aryepiglottic folds in either voiceless (fricative) or voiced (approximant) mode. A pharyngeal plosive is identified by full occlusion of the aryepiglottic sphincter. "Epiglottal" sounds, which have been described auditorily as "deeper" or "more extreme" than pharyngeals, are associated with either the trilled varieties of the simple fricative or approximant, or the default raised larynx posture of the aryepiglottic sphincter, with radical retraction of the tongue. They are therefore more severely constricted, but not physiologically "deeper" than simple [symbol: see text] or [symbol: see text]. Pharyngeal articulations may also be produced with larynx lowering. Voiceless pharyngeal [symbol: see text] may be accompanied by lowering of the larynx to distinguish it from a larynx-raised [H] variant. Larynx height variations are also found in "tense/lax" register distinctions.

Epiglottis↗

Morphological assessment of pathological changes within the rat larynx.

Routine histological examination of the rat larynx, from inhalation toxicity and carcinogenicity studies, has been routinely performed in this laboratory for over 15 yr. This work has identified the larynx as an important target organ with a number of pharmaceuticals, industrial chemicals, agricultural chemicals, and environmental pollutants. The rat larynx contains 5 epithelial types: stratified squamous; low squamoid; respiratory; and 2 forms of pseudostratified cuboidal epithelium. Each epithelial type has a specific location within the relatively complex anatomical configuration of the larynx. The detection of induced changes requires a consistent, thorough and detailed histological examination in order to identify the often subtle changes in the distribution of these epithelial types. Induced lesions show distinct predilection sites, including the ventro-lateral regions anterior to the ventral pouch and the inner aspects of the arytenoid projections. Lesions commonly involve degeneration of the original epithelial cells with subsequent regeneration; hyperplasia and squamous metaplasia. In more severe reactions, the larynx may illustrate epithelial ulceration with exudation. To some extent the changes commonly observed are dependent upon the duration of the study and the dose level employed, rather than the individual compound. Recovery or regression of induced changes is variable and dependent upon the time scale involved and severity or type of initial lesion.

Animals↗

Opening and closing mechanisms of the larynx.

Opening and closing of the larynx are determined by the intrinsic and extrinsic muscles acting on the elastic forces in the tongue, pharynx, larynx, and trachea. The pharynx is opened or closed by two mechanisms: (1) Contractions of the cricothyroid and of the intrinsic muscles of the larynx open and close the vocal cords. (2) The false cords, ventricle, and true cords accordion open or close in a bellows mechanism. We conclude that the posterior cricoarytenoid opens the laryngeal airway. The cricothyroid together with the posterior cricoarytenoid accentuates this opening. The larynx is also opened by the geniohyoid, mylohyoid, sternothyroid, and middle constrictor. The thyrohyoid, cricothyroid, sternohyoid, and inferior constrictor close the laryngeal airway. Abnormalities in the soft tissues of the neck or of the innervation of the larynx, pharynx, and neck muscles may severely interfere with patency of the laryngeal airway. This occurs in such conditions as vocal cord paralysis, sleep apnea, multiple sclerosis, amyotrophic lateral sclerosis, spastic dysphonia, mandibular fractures or hypodevelopment, and cerebrovascular disease.

Animals↗

Local immune system in the developing fetal larynx.

Using histopathological and immunofluorescent techniques, we investigated the development of the glandular system of the larynx from 12 human fetuses. Glandular buds were first observed at the fourth month of gestation and glandular distribution became evident from the fifth month in the larynx. Ciliated or nonciliated epithelium covered the cavity of the larynx, with the exception of the true vocal cord. Immunofluorescent examination revealed the presence of IgG in the fetal larynx, but there was little fluorescence for IgA, IgM and IgE. Secretory component (SC) synthesis, on the other hand, was found in each serous-type glandular epithelium or acinus from the fourth month on. Our observations suggest that the local immune system by SC, which binds to IgA as SIgA in human laryngeal mucosa, is inherently acquired in the fetal larynx.

Epithelium↗

Effects of acid on the larynx of the maturing rabbit and their possible significance to the sudden infant death syndrome.

Sudden infant death syndrome (SIDS) has been shown to result from a variety of causes. One group of neonates at high risk for SIDS includes those who develop apnea secondary to gastroesophageal reflux (GER). Reflux has been shown to produce apnea in infants, and aggressive treatment results in significant improvement in symptoms. Because it is a site of resistance in the airway, the larynx plays an important role in the development of apnea. Through its sensory innervation, the larynx also serves as the afferent limb for reflexes that regulate respiration. In order to investigate the relationship between obstructive apnea and central apnea induced by the instillation of acid on the larynx, simulating GER, a rabbit model was developed. Maturing rabbits at 15-day intervals up to 60 days of age were studied using saline and acid solutions. Acid solutions produced obstructive apnea in all age groups. With acid solutions, central apnea occurred in all age groups but had a peak incidence at 45 days. Gasping respirations were seen in all groups but were most common at 30 days of age. Although obstructive and central apnea occurred together as mixed apnea, both types of apnea were seen independently of each other. Acid instilled on the larynx of maturing rabbits resulted in significant obstructive, central, and mixed apnea. Gasping respirations and frequent swallowing were frequent associated symptoms. Acid-induced obstructive apnea in rabbits mirrors symptoms seen in human infants with GER. Central apnea in infants with GER is seen less commonly; however, central apnea as the result of laryngeal stimulation has been demonstrated repeatedly in several animal models. Central apnea, culminating in fatal asphyxia, has been described in several animal models. The larynx appears to play a pivotal role in the development of apnea in susceptible infants with GER.

Aging↗

In reference to phonation larynx fixation: computer graphic record.

The vocal apparatus serves phonation. It represents a biocybernetic self-regulating system, disposing of a feedback network of the central nervous system. The larynx is a self-induced vibrating system. The larynx, functioning as the phonation apparatus of the vocal apparatus, is a source of human voice. In every individual its frequency range corresponds to about eight semitones in speech and about two octaves of the so-called chest register in singing, denoted also as a thoracic or modal voice. This is followed by one more octave of the so-called cranial register or falsetto voice. We were interested in changes of the larynx positions at intonation in the fundamental singing registers, both modal and falsetto, in professional male singers. At our disposal were 11 professional male singers. We investigated changes in the position of the laryngeal structures simultaneously with the aid of an X-ray apparatus, the acoustic and mechanical signals registered by means of the B & K 4369 acceleration recorder. It has been found that at phonation with the modal voice a change in the position of the laryngeal structures takes place in two different ways, whereas the larynx movements at falsetto remain the same. It has been suggested that a complex fixation apparatus participates in the phonation larynx movements. Of the same complex character are also the problems connected with the examination of the entire vocal apparatus. For the purpose of compiling the present pieces of knowledge in the field of human voice studies, we have made the most advantageous use of the presently most complex system Authorware for the production of some interactive multimedial programmes on personal computers.

Computer Graphics↗

[Objective evaluation of respiratory function of the larynx after partial laryngectomy of various range].

The aim of the study was to identify factors and their effect on the respiratory efficiency of the larynx after partial laryngectomy. The material consisted of 72 patients aged 30 to 71 years (mean 54.3 years) who underwent partial laryngectomy due to cancer, and 10 healthy volunteers aged 22 to 29 years (mean 24.5 years). Airflow was measured under normal conditions and upon application of external resistance. Methods included history taking and physical examination, spirometry, laryngovideoscopy (Lvs), and computed tomography (CT) of the larynx. Some airflow parameters were decreased prior to surgery in comparison to predicted values. In a majority of patients, surgery had a negative effect on all parameters of airflow. Reduction was greater for inspiratory than expiratory parameters. Analysis of the shape of flow-volume loops in patients after surgery showed that the mixed type prevailed. This is characterized by reduction of the inspiratory and expiratory parameters, with greater effect on the inspiratory phase. Morphologically, the mixed type corresponds to narrowing of various extent with flaccid wall stenosis. The flow-volume shape changed dynamically during the healing process of the larynx until normalization was observed. This process was independent of the type of surgery but depended on the size of the laryngeal lumen and wall stiffness. Significant differences were found when laryngeal lumen was measured using CT or Lvs, with Lvs being more accurate. Lung volume parameters remained unchanged, but a statistically significant relationship with lumen size was observed both in experimental and clinical investigations. The most useful parameters for estimating laryngeal airflow were: PIF, FIF50, FIV1, FIV1%/N FEV1 and % Rz/N PEF. Upper and lower values were established for PIF (1.4-2.0 L/s), FIF50 (0.7-1.9 L/s), FIV1 (0.7-1.6 L), FIV1%/N FEV1 (40-60%),% Rz/N PEF (20-40%) on the basis of which the decision to restore respiration through the larynx (decannulation) may be made. It can be concluded from the results that spirometry and Lvs are more accurate than CT for assessment of the respiratory function of the larynx after partial laryngectomy.

Adult↗

[Influence of treatment of inhaled corticosteroids on the function of the larynx in asthmatic patients].

UNLABELLED: The objective of the study was to examine influence of inhaled glycocorticosteroids on phoniatric function of the larynx in patients suffering from asthma. MATERIAL AND METHODS: Thirty minutes after the administration and long-term therapy effect of the inhaled glycocorticosteroids on local condition of the phoniatric organ was assessed in 15 patients with recently diagnosed bronchial asthma. The diagnostics of asthma included: subjective and objective examination, prick tests, spirometry, total IgE and histamine test for bronchial hyperactivity. Evaluation of voice function was implemented subjectively and objectively with use of videolaryngostroboscopy (VLSS). Acoustic assessment of voice was also performed. RESULTS: Administration of glycocorticosteroids as inhaled discs resulted in incidents of cough, mouth and throat dryness, sensation of polydipsia and skin inflammation around the mouth. Occasionally, hoarseness and discomfort in the larynx area were noted. On long-term administration, dysphonia, hoarseness and voice fatigue due to dysfunction of innermost larynx muscles, particularly vocal fold adductors. After 30 minutes of the glycocorticosteroid administration in patients with recently diagnosed asthma, irritation of the pharynx and larynx mucosa was recorded. CONCLUSION: The long-term treatment with inhaled glycocorticosteroids resulted in myopathy of proper muscles of the larynx.

Administration, Inhalation↗