National Journal of Medical Research (Sep 2013)
COMPARISON OF ORAL AND LARYNGEAL FINDINGS OF ASTHMA PATIENTS USING DIFFERENT DRY POWDER INHALER DEVICES CONTAINING STEROID AND BETA AGONISTS
Abstract
Objective: In this study, we aimed to compare the oral and laryngeal findings of asthma patients using different dry powder inhalers (DPI) containing corticosteroid and long-acting beta-2 agonists. Methods: This study included 109 asthmatics who were divided into 3 groups according to the inhaler device (Seretide Discus [fluticasone 250 mcg, salmeterol 50 mcg], Symbicort Turbuhaler [budesonide 320 mcg, formoterol 9 mcg], and Foradil [formoterol 12 mcg] + Miflonide [budesonide 400 mcg] aerolizer), and compared with 34 healthy controls. Oral and laryngeal regions were examined comprehensively by a rigid telescope. Results: While frequency of oral candidiasis was higher in the group taking budesonide + formoterol by an aerolizer than those of other DPI using groups, frequency of laryngeal candidiasis was more elevated in asthma patients compared to those of healthy controls (p<0.05). Frequency of vocal fold hyperemia and edema was lower in asthma patients taking budesonide + formoterol combination by a Turbuhaler compared to those of other DPI using groups (p<0.05), it was higher in asthmatics than that of healthy controls, and it was also determined to be higher in asthmatics with dysphonia compared to that of asthmatics with a normal voice (p<0.05). Conclusion: In the present study, a high rate of oral and laryngeal abnormalities was determined in asthmatics using DPI with a lower rate in asthmatics taking budesonide + formoterol by a Turbuhaler. Further studies with more comprehensive oral and laryngeal examinations before and after treatment may provide more information on this aspect.