Voice hoarsness and asthma inhalers

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I have an ongoing issue which is really getting me down. I am 32 years old and I have always had a moderately high pitched voice. This doesn't bother me, however when I take inhaled steroid sprays for asthma, my voice becomes much more weak, breathy, hoarse and even higher in pitch. I struggle to project my voice and it's a real strain in public settings.
I've tried many different steroid preventer inhalers, and they all seem to cause this voice problem.

I went to see an Otorhinolaryngologist at the hospital who checked over my vocal chords, he wondered if I may have a bilateral sulcus vergeture, causing the higher pitch, but after several attempts at voice therapy, I was not able to reduce the pitch of my voice. They didn't seem to concerned about my problems with inhalers, which is a big problem for me as I need to have well controlled asthma and not live in a precarious balance of only taking my preventers when my asthma symptoms worsen..

I don't know if my high pitched voice is in any way related to my inhaler problems but I really want to have controlled asthma and not have a hoarse voice as a result. Is there anything i can do to help? I have tried every inhaler under the sun it seems, I use a spacer and I gargle, but nothing seems to help.

Many thanks for your help.

James P Thomas MD's picture
Submitted by James P Thomas MD on Tue, 2012-09-11 11:49

You actually have a couple of different questions here, at least one about your pitch and another about steroids, perhaps one about hoarseness, and perhaps another about whether your own ORL has been able to accurately diagnose the problem. If your voice is high-pitched, then there is a reason for it. Generally shorter, thinner and tighter vocal cords vibrate at higher pitches and longer, thicker and looser vocal cords vibrate at lower pitches. So first you and your physician need to decide whether your issue is a bilateral sulcus vergeture or not. If you have thin vocal cords ( the underlying problem in sulcus vergeture), then doing something to thicken them will be the appropriate approach to correcting your pitch issue.

If your issue is hoarseness, then your physician and you will need to decide if the hoarseness is from air leak or from asymmetric vibrations and then correct that problem. Since you may or may not have bilateral sulcus vergeture, may or may not have fungal growth (the most common cause of stiffness in patients that use steroid inhalers) or may or may not have some other problem that I am not able to see, not having examined her vocal cords, your best approach will be to get an accurate diagnosis.

I list the laryngologists that I know on this website who might be interested in helping you with your diagnosis and may have more experience than a general ORL.