Role of steroids in acute phonotrauma: A basic science investigation.

Abstract

OBJECTIVES/HYPOTHESIS:

Steroids are used for the treatment of laryngitis in vocal performers and other individuals despite the absence of evidence demonstrating their impact on vocal fold inflammation. Our objective was to examine laryngeal secretion cytokine inflammatory profile changes associated with corticosteroid treatment in a human phonotrauma model.

STUDY DESIGN:

Prospective, individual, randomized, double-blinded, controlled trial.

METHODS:

Participants included 10 healthy females who were randomized to either treatment with oral hydrocortisone or placebo, each given in three doses over 20 hours after the experimental induction of acute phonotrauma. Cytokines associated with inflammation and healing (interleukin [IL]-1β, IL-6, IL-10) were measured in laryngeal secretions before and after vocal loading and at 4 and 20 hours after treatment.

RESULTS:

Proinflammatory mediators IL-1β and IL-6 were doubled in the controls versus the steroid treatment group at 21 hours following induction of acute vocal fold inflammation. Anti-inflammatory cytokine IL-10 showed a 6.3-fold increase in the steroid treatment group versus the controls, indicating anti-inflammatory modulation by steroid treatment.

CONCLUSIONS:

This study provides biologic evidence supporting the use of steroids for acute vocal fold inflammation associated with phonotrauma.

LEVEL OF EVIDENCE:

1b.

• Authors: John W Ingle, Leah B Helou, Nicole Y K Li, Patricia A Hebda, Clark A Rosen, Katherine V Abbott
• Journal: The Laryngoscope (Laryngoscope) Vol. 124 Issue 4 Pg. 921-7 (Apr 2014) ISSN: 1531-4995 [Electronic] United States
• PMID: 24474147 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: © 2014 The American Laryngological, Rhinological, and Otological Society, Inc.

Chemical References

• Anti-Inflammatory Agents
• Cytokines
• Hydrocortisone

Topics

• Acute Disease
• Administration, Oral
• Adolescent
• Adult
• Anti-Inflammatory Agents (administration & dosage)
• Cytokines (metabolism)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Female
• Follow-Up Studies
• Humans
• Hydrocortisone (administration & dosage)
• Laryngitis (etiology, metabolism, prevention & control)
• Neck Injuries (complications, metabolism)
• Prospective Studies
• Treatment Outcome
• Vocal Cords (drug effects, injuries)
• Voice Quality (drug effects)
• Wound Healing (drug effects)
• Young Adult