Elucidating Fungal Laryngitis Associated with Inhaled Corticosteroid Use
Poster #: 113
Session/Time: B
Author:
Simran Ketan Shah, BS
Mentor:
Benjamin Rubinstein, MD
Research Type: Clinical Research
Abstract
INTRODUCTION:
Inhaled corticosteroids (ICS) are a mainstay in the treatment of asthma and COPD due to their potent local anti-inflammatory effects. However, ICS use is associated with adverse effects, particularly dysphonia, which is the most frequently reported symptom. Fungal laryngitis, a potential underlying cause of dysphonia, often goes undiagnosed due to low clinical suspicion and underutilization of diagnostic tools such as laryngoscopy, videostroboscopy, and fungal cultures. This study investigates the relationship between ICS use and fungal laryngitis and seeks to improve diagnostic pathways for this condition.
METHODS:
The study will utilize a prospective observational cohort study to identify 50 cases (used ICS daily for one month prior) and 5 controls within Sentara Pulmonary, Critical Care & Sleep Specialists clinic. Participants are evaluated at the EVMS Otolaryngology Clinic using a combination of validated questionnaires-Voice Handicap Index (VHI), EAT-10, Reflux Symptom Index (RSI), and Newcastle Laryngeal Hypersensitivity Questionnaire (NLHQ)-as well as through fungal culture, flexible nasolaryngoscopy, and/or videostroboscopy. Concurrently, a retrospective chart review is being conducted to assess diagnostic patterns and further examine the association between ICS use and fungal laryngitis.
RESULTS:
As of September 2025, nine participants have consented to the prospective study, with eight completing clinic visits. Additionally, 234 patient charts have been reviewed and entered into REDCap for retrospective analysis, focusing on symptoms and test results before and after antifungal treatment.
CONCLUSION:
Recruitment for the prospective cohort will continue through 2025. Data from both the prospective and retrospective components will be analyzed using multivariate regression and descriptive statistics. The combined findings aim to clarify the prevalence of fungal laryngitis in ICS users and evaluate and improve upon current diagnostic approaches.
Inhaled corticosteroids (ICS) are a mainstay in the treatment of asthma and COPD due to their potent local anti-inflammatory effects. However, ICS use is associated with adverse effects, particularly dysphonia, which is the most frequently reported symptom. Fungal laryngitis, a potential underlying cause of dysphonia, often goes undiagnosed due to low clinical suspicion and underutilization of diagnostic tools such as laryngoscopy, videostroboscopy, and fungal cultures. This study investigates the relationship between ICS use and fungal laryngitis and seeks to improve diagnostic pathways for this condition.
METHODS:
The study will utilize a prospective observational cohort study to identify 50 cases (used ICS daily for one month prior) and 5 controls within Sentara Pulmonary, Critical Care & Sleep Specialists clinic. Participants are evaluated at the EVMS Otolaryngology Clinic using a combination of validated questionnaires-Voice Handicap Index (VHI), EAT-10, Reflux Symptom Index (RSI), and Newcastle Laryngeal Hypersensitivity Questionnaire (NLHQ)-as well as through fungal culture, flexible nasolaryngoscopy, and/or videostroboscopy. Concurrently, a retrospective chart review is being conducted to assess diagnostic patterns and further examine the association between ICS use and fungal laryngitis.
RESULTS:
As of September 2025, nine participants have consented to the prospective study, with eight completing clinic visits. Additionally, 234 patient charts have been reviewed and entered into REDCap for retrospective analysis, focusing on symptoms and test results before and after antifungal treatment.
CONCLUSION:
Recruitment for the prospective cohort will continue through 2025. Data from both the prospective and retrospective components will be analyzed using multivariate regression and descriptive statistics. The combined findings aim to clarify the prevalence of fungal laryngitis in ICS users and evaluate and improve upon current diagnostic approaches.