Assessment of Vocal Folds Changes and their Correlation with Pulmonary Functions in Asthmatic Children

Objectives: Asthma is a chronic inflammatory disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. There are a lot of co-morbid conditions associated with asthma. Among this co-morbid conditions are vocal folds changes. The prevalence of co-morbidities seems to be particularly high in severe asthma, and may be particularly detrimental to asthma control in such individuals. Inhaled corticosteroids (ICS) are by far the most effective controllers used in the treatment of asthma and the only drugs that can effectively suppress the characteristic inflammation in asthmatic airways, even in very low dose. ICS has side effects due to its local deposition in the oropharynx and larynx, but the frequency of complaints depends on the dose and frequency of administration. Patients and Methods: The purpose of this study to assess vocal folds abnormalities in asthmatic children as well as the influence of different doses of inhaled corticosteroids on it. A Total number of 36 Egyptian children are included in this study divided into 3 groups: group I (asthmatic children on ICS) group II (newly diagnosed asthmatic children) and group III (controls). For all patients and control, history taking, chest examination, CBC, Spirometery PFTs (Pulmonary function tests: FEV1 and MMEF), video laryngoscope (VLS) and Multi-dimensional voice analysis (MDVP) were done. Results: Video Laryngoscope (VLS) examination of asthmatic patients (number = 24 cases) revealed different abnormalities in 13 cases (54.2%), 4 cases on ICS, 9 cases not on ICS. Those abnormalities were, Reink's edema (2 cases), moderate congestion of the larynx (2 cases ), bilateral swellings of both vocal folds (2 cases), vocal fold cyst (1 case ), left vocal fold swelling (2 cases), congestion and edema of both vocal folds (1 case), bilateral thickening of both Vocal folds (1case), bilateral vocal folds nodules (1case), Phonatory waste (1case). The Video Laryngoscopic (VLS) examination of the control group revealed no abnormalities. Conclusion: 1-Asthmatic patients may have an associated Laryngeal or vocal folds abnormalities which may be one of the causes of poor asthma control.