Vocalist.org archive


From:  "John Messmer, M.D." <jjm23@p...>
Date:  Sun Sep 10, 2000  7:12 am
Subject:  Re: [vocalist-temporary] MED: Nasacort spray??


> I have been prescribed Nasacort nasal spray by my ENT for clearing my
> nose of constant allergic stuffiness.
>
> Please can the list comment on using this or other corticosteroid
> treatment for allergies. The doctor said it takes about a month for
First, I'd like to clear up an apparent misconception that some of the
replies seem to be causing. There are steroid sprays for the nose and for
the lungs. The medications inhaled are the same, but the route is
different. When a NASAL spray is used, it is practically impossible to get
it on the vocal folds. It will not affect them. On the contrary if you
have allergies, it will help your voice and breathing.

Sprays for the lungs are used to treat asthma. If inhaled properly, the
effect on the folds is minimal to none. Proper inhalation involves getting
the spray suspended in the airstream and inhaling deeply. The droplets are
so microscopic if done properly, almost none touch the folds. The problem
is that it is rare that anyone does it properly without a chamber for the
spray to suspend the medication first.

In my experience (FWIW) triamcinolone is best tolerated on the folds,
although beclomethasone is fairly well tolerated too. The others are more
potent. However, if you have asthma and get trouble more than once a month,
you can save your life by regular use of an inhaled steroid. Just use a
chamber for the spray to protect your vocal folds.

In some cases, one can get relief from asthma with the use of a leukotriene
receptor blocker, such as, montelukast (Singulair). This is a pill and may
turn out to be just as good as inhaled steroids in those who respond to it.

John

John Messmer, M.D.
Assistant Professor Family and Community Medicine
Penn State College of Medicine


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