Structural and vocal effects of combined inhalational therapies in obstructive lung disease: A review

Obstructive lung diseases (OLD), such as chronic obstructive pulmonary disease (COPD) and asthma, rely heavily on combined inhalational medications, including inhaled corticosteroids (ICS) and bronchodilators, for management. While these therapies target airway inflammation and obstruction, their localised effects on the larynx remain insufficiently characterised. This review synthesises evidence on laryngeal consequences, focussing on structural alterations and dysphonia as adverse effects of combined ICS-bronchodilator regimens. We explore histopathological changes, clinical manifestations and the underexplored potential of vocal assessment as a diagnostic and monitoring tool. By integrating pulmonary and otolaryngological perspectives, we highlight gaps in current knowledge and propose directions for future research to optimise patient outcomes in OLD.