It is always important to know what is going on in the world of COPD/Asthma, hence a new weekly (at the minimum) posting of ‘Notes to Know about COPD/Asthma’ – because those of us battling the issue should always be up to date on what is going on, and that includes both the positives and the negatives of the COPD/Asthma life.

Many, if not most, of those with COPD and/or Asthma are dealing with some type of inhaler medications, of which many are steroid based.  This can lead to a variety of problems, one of which we will share an interesting write found during an internet search with the question “can inhalers cause problems for the larynx?”.

Special Note – This subject can get personal with this writer as I have parlysis on one side of my larynx.  While no doctors have said conclusively, they have indicated that my parents and I may be close to the answer in stating it could have been caused by the large use of aerosol type inhalers as a during by childhood through teenage years.  Needless to say, my voicebox still gives me problems not just with talking at times, but also with swallowing.

With that, read on and see if you can relate to this particular problem with your larynx when using an inhaler.

(The following article was found during an internet search and was written by Dr. Christopher Chang who is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat.)

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Steroid Inhalers for Asthma Can Cause Fungal Laryngitis

It is a big bummer to be an asthmatic. Not only is breathing a problem, but even the treatment for asthma can cause problems.

Take for example steroid inhalers like advair, symbicort, fluticasone, etc.

All asthma patients know to rinse their mouth out after inhaler use due to risk of oral thrush, but what about from the back of the mouth down to the vocal cords??? This nether region can’t be gargled very easily. One can swallow water to rinse this area out, but the vocal cord region would still not be addressed (otherwise aspiration would occur).

And that leads to potential vocal problems… like fungal laryngitis (or thrush of the voicebox). Here’s a picture of what that looks like. To compare, normal is shown in the smaller picture.

Larynx    Larynx--Good

Note the white patches indicative of fungal growth. This fungal infection can lead to symptoms of a mild (if any) sore throat, but most patients complain of hoarseness as their only symptom.

Treatment is ideally to stop the steroid inhaler triggering the infection, but if an asthmatic needs it… than they need it. As I often tell patients, breathing is more important than voice. Often, anti-fungal medications like diflucan and nystatin can eliminate the fungal laryngitis, but the problem is, as long as steroid inhalers are used, it comes right back. And repetitive anti-fungal treatment can place the patient at risk for a drug-resistant fungal infection.

So, what to do???

There is one type of little-known (unpleasant) treatment an asthmatic patient can perform to minimize risk of fungal laryngitis while still maintaining steroid inhaler use.

It’s called laryngeal washes and it takes a lot of time, patience, and period of discomfort. Think of it as gargling of the voicebox.

The patient takes a curved luer-lock cannula (picture shown) attached to a syringe filled with salt-water. Cannula--CurvesToWashLarynx  While opening the mouth and sticking the tongue out, the curved end of the cannula is directed such that the end is pointed straight down into the throat. After taking a deep breath in, while saying “ah”, salt-water is dripped down into the throat thereby “gargling” the voicebox. Coughing may be inevitable after performing.

This needs to be done after every steroid inhaler use. Or during an active fungal infection, at least 4 times per day.

Gagging is the biggest problem preventing correct usage of this technique. Coordinating the injection while saying “ah” is another issue since if it is incorrectly performed, can lead to aspiration and severe coughing. As such, it is not for everyone.

One can purchase such “luer-lock laryngeal cannulas” from any ENT medical supply company.

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‘Notes to Know about COPD/Asthma’ will continue to feature writings from medical folks and caretakers who share insights into the world of what may be going on in the world of COPD/Asthma.  ‘Notes to Know about COPD/Asthma’ can be found at either or within the Facebook page, COPD Travels.

Remember – ‘a person without good breathing, is a person without a good life’, so let’s do what we can, to learn what we can, to improve what we can.

I bid to all – smiles, prayers, blessings and steady breathing – Mr. William.

(Copyright@2017, CrossDove Writer through – no part of this write may be used or copied without written permission.)

NOTES: Sometimes we share what may seem like medical information, but we are only giving descriptions and highlights of various aspects of having COPD and/or asthma and no way do we ever want our information to be considered medical treatment type of information, always consult your physician for more, clearer and more medical founded information.