Williams A J, Baghat M S, Stableforth D E, Cayton R M, Shenoi P M, Skinner C
Thorax. 1983 Nov;38(11):813-21. doi: 10.1136/thx.38.11.813.
Nine of 14 asthmatic patients who presented with persistent dysphonia while taking inhaled corticosteroids had a bilateral adductor vocal cord deformity with bowing of the cords on phonation. This causes the dysphonia and usually occurs without candidiasis. It was seen with beclomethasone dipropionate (in both pressurised aerosol and dry powder preparations), betamethasone valerate, and budesonide. It was related to the dose and potency of inhaled steroid and may represent a local steroid myopathy. It was reversed when the inhaled steroid was stopped, although resolution sometimes took weeks. Laryngeal candidiasis may have contributed to the vocal cord abnormality in two of these nine patients. Of the five patients without vocal cord deformity, laryngeal candidiasis was the sole cause of dysphonia in three. In the remaining two dysphonia was thought to be psychogenic. The vocal cord deformity may exist subclinically. Of nine patients who started to take aerosol steroid and who were examined monthly for one year, three developed vocal cord deformity but only one had persistent dysphonia. Vocal abuse did not appear to contribute to dysphonia.
14例在使用吸入性糖皮质激素时出现持续性发音障碍的哮喘患者中，有9例存在双侧内收性声带畸形，发声时声带呈弓形。这导致了发音障碍，且通常在无念珠菌病的情况下发生。在丙酸倍氯米松（气雾剂和干粉制剂）、戊酸倍他米松和布地奈德使用过程中均有发现。它与吸入性类固醇的剂量和效力有关，可能代表一种局部类固醇肌病。停用吸入性类固醇后畸形可逆转，尽管有时需要数周才能恢复。在这9例患者中有2例，喉念珠菌病可能促使了声带异常。在5例无声带畸形的患者中，3例发音障碍的唯一原因是喉念珠菌病。其余2例发音障碍被认为是心因性的。声带畸形可能以亚临床形式存在。在9例开始使用气雾剂类固醇并接受为期一年每月检查的患者中，3例出现了声带畸形，但只有1例有持续性发音障碍。发声滥用似乎与发音障碍无关。
