Combination inhaled corticosteroids (ICs) are the primary treatment prescribed for patients with asthma; however, voice problems are also associated with ICs. In this study, 32 rabbits were assigned randomly to one of five experimental groups: baseline, induction, induction control, reversibility, and reversibility control. The baseline group received no treatment and larynges were obtained following quarantine. Rabbits belonging to experimental groups received IC treatment twice a day until trained raters noted visible vocal fold changes during endoscopy, which was performed every 2 weeks. When changes were observed, animals were euthanized, and the larynges were harvested from the experimental induction group and the corresponding control group. The remaining rabbits entered a withdrawal phase wherein ICs were discontinued, and endoscopy was performed every 2 weeks until visual-perceptual ratings indicated a return to baseline. Subsequently, all excised larynges underwent benchtop phonation trials to acquire aerodynamic data relating to vocal fold functioning at phonation onset. Analysis included 17 rabbits from the previous phase of the study and showed an increase in phonation threshold pressure (PTP) and phonation threshold flow (PTF) following IC use compared to the control groups. Rabbits in the experimental withdrawal group showed lower PTP and PTF compared to the induction group, but still greater values than the control groups. These results indicate IC-related adverse vocal effects may decrease after treatment is withdrawn but might not reverse completely. These findings indicate a trend toward recovery when ICs are withdrawn but lay critical groundwork for future studies involving asthma management and IC-driven voice disorders.

The purpose of the present study was to examine the effects of external laryngeal vibration on voice function. The current study was based on a recent pilot study using silicone vocal folds that demonstrated a decrease in phonation threshold pressure (PTP; cmH2O) when an external oscillation was applied to the vocal folds. Using a within-subjects experimental design, a custom external oscillatory device was fitted to the posterior portion of 12 excised pig larynges using a traditional benchtop phonation setup. For each larynx, phonation was elicited during 30 repeated trials, including 15 with and 15 without external oscillation. During the phonation trials, aerodynamic measures were collected. The outcome measure for this study was PTP, which has been established in the literature as being correlated with physiologic and self-perceived vocal effort. Furthermore, PTP is used routinely as an aerodynamic indicator of voice function, vocal efficiency, and the nature and severity of voice disorders. Although the aim was to quantify either positive (i.e., PTP decrease) or negative (i.e., PTP increase) effects of external oscillation on PTP, it was hypothesized that external oscillation would result in a reduction in average PTP values. The results of the study indicate that application of an external oscillatory device results in significantly lower PTP. These findings have important clinical implications for PTP signal acquisition and the potential use of external oscillation as a therapeutic tool to improve voice function.

This thesis is part of a larger series of studies being conducted by Kristine Tanner, PhD, Associate Professor in the Department of Communication Disorders at Brigham Young University (BYU). The larger project is funded by the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health. This thesis primarily investigated the effects of combination inhaled corticosteroids (ICs) on aerodynamic measures of the voice. In recent years, an increase in the localized laryngeal side effects from IC treatment, including dysphonia, have been reported. This study employed a between-groups experimental design, with two groups of rabbit larynges having been exposed to either ICs or nebulized isotonic saline two times each day for eight weeks at The University of Utah. For this study, the independent variable is group condition (i.e., IC versus saline) and the dependent variables are two aerodynamic measurements made at the onset of phonation using a benchtop experimental setup, namely phonation threshold pressure (PTP; cmH2O) and phonation threshold flow (PTF; L/min). The results of this study indicate a significant difference in PTP and PTF between vocal folds treated with IC as compared to vocal folds treated with nebulized isotonic saline solution. Implications of this study suggest negative changes in the voice due to IC treatment.

Although combination inhaled corticosteroids (ICs) are known to cause voice disorders in otherwise vocally healthy individuals, it is unknown whether those adverse effects can be reversed by the cessation of treatment. Quantitative aerodynamic measures such as phonation threshold pressure (PTP) and phonation threshold flow (PTF) can be used to identify the development of, and recovery from, vocal pathologies. We examined the effects and reversibility of ICs on laryngeal aerodynamics. This study was a mid-project investigation as part of a larger ongoing project. The 18 larynges were from rabbits that received ICs, a control condition, or no treatment. Experimental group rabbits received ICs twice per day until inflammatory changes (e.g., erythema, edema) became visible through endoscopic observation. One experimental group (i.e., the induction group) received treatment until symptoms were observed and then larynges were harvested. The other experimental group (i.e., the reversibility group) had ICs withdrawn once visible changes were detected via endoscopy; larynges were harvested only after these changes no longer differed from baseline. Both experimental groups had corresponding control rabbits that received twice-daily nebulized saline and followed the same withdrawal and larynx harvest schedule. A final group received no treatment. During benchtop phonation trials, PTP and PTF values were determined. All data were analyzed using descriptive and parametric statistics. No significant between-group differences were observed. Descriptively, however, average PTP and PTF values for the reversibility group were lower than the induction group. Additionally, average PTP and PTF values for the reversibility group were slightly lower than the induction group. Both experimental groups had higher PTP and PTF values than the control larynges. The results of this study indicate a trend in recovery for larynges afforded a recovery period from ICs. Further testing is needed to substantiate these preliminary findings.