Laryngeal Dysfunction in Severe Asthma: A Cross-Sectional Observational Study

Abstract

Laryngeal disorders can contribute to disease burden in severe asthma yet the nature of laryngeal disorders in severe asthma is poorly understood. The aim of this study was to examine laryngeal function in patients with severe asthma. A cross-sectional observational study involving 97 participants compared laryngeal function in patients with severe asthma (n= 53) with patients with laryngeal disorders of vocal cord dysfunction/inducible laryngeal obstruction (n= 16) and muscle tension dysphonia (n= 14), and with 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. 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 after therapy, and laryngeal dysfunction improved in 7 (64%) participants. Laryngeal dysfunction affects respiration and phonation in severe asthma. It requires identification and treatment to minimize its impact on asthma symptoms.