Tanner K, Robison HJ, Stevens ME, Merrill RM, Dromey C, Barkmeier-Kraemer J, Ben Christensen M. Corticosteroid-LABA inhalers increase phonation threshold pressure (PTP) and flow (PTF) in rabbits.
Laryngoscope 2023;
133:2680-2686. [PMID:
36757019 PMCID:
PMC10409873 DOI:
10.1002/lary.30585]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES
This study examined the effects of a combination corticosteroid plus long-acting beta2 -adrenergic agonist inhaler (IC) on rabbit phonation.
METHODS
White New Zealand male rabbits were assigned randomly to experimental and control groups (n = 11 per group). The experimental group received twice-daily doses of Advair HFA™ (fluticasone propionate 45 mcg and salmeterol 21 mcg) via a veterinary facemask with 1-way valve and spacer; the control group received aerosolized saline. After 8 weeks, animals were euthanized, larynges excised, frozen, and subsequently thawed and mounted on a standard bench apparatus. Phonation was elicited during 15 successive trials, and phonation threshold pressure (PTP; cmH2 O) and flow (PTF; L/min) were quantified.
RESULTS
Repeated measures analysis of variance indicated significant differences between the experimental and control groups (p < 0.05). Mean PTP and PTF values were higher (worse) for rabbits that received Advair HFA™.
CONCLUSION
Following 8-week exposure to ICs, rabbit larynges required greater air pressure and flow to initiate phonation. Because even modest phonation onset differences can have a meaningful clinical impact on voice function, these findings suggest that LABA ICs may put patients at risk for voice disorders. Furthermore, these voice disorders may occur within a relatively short timeframe. The results from this study have important clinical implications for voice care in those who use ICs.
LEVEL OF EVIDENCE
NA Laryngoscope, 133:2680-2686, 2023.
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