Laryngeal dysfunction in severe asthma: A cross sectional observational study.

ABSTRACT Background Laryngeal disorders can contribute to disease burden in severe asthma yet the nature of laryngeal disorders in severe asthma is poorly understood. Objective The aim of this study was to examine laryngeal function in patients with severe asthma. Method A cross sectional observational study involving 97 participants compared laryngeal function in patients with severe asthma (n=53) to patients with laryngeal disorders of vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO) (n=16) and muscle tension dysphonia (MTD) (n=14), and to healthy controls (n=13). A pre-post pilot study of speech pathology intervention for laryngeal symptoms was then provided to 11 participants with severe asthma and laryngeal dysfunction. Results Laryngeal dysfunction was common in severe asthma. The majority of participants with severe asthma (87%) had laryngeal dysfunction which affected respiration, phonation or both. Three distinct patterns of laryngeal dysfunction in severe asthma were identified (1) phonatory laryngeal dysfunction, (2) respiratory laryngeal dysfunction, and (3) combined laryngeal dysfunction. Laryngeal hypersensitivity and impaired voice measures were common in severe asthma Patient reported outcome measures improved following therapy and laryngeal dysfunction improved in seven (64%) participants. Conclusion Laryngeal dysfunction affects respiration and phonation in severe asthma. It requires identification and treatment to minimise its impact on asthma symptoms.