Comparing nebulized water versus saline after laryngeal desiccation challenge in Sjögren's Syndrome

Laryngoscope. 2013 Nov;123(11):2787-92. doi: 10.1002/lary.24148. Epub 2013 May 14.


Objectives/hypothesis: This study examined the effects of a laryngeal desiccation challenge and two nebulized hydration treatments on phonation threshold pressure (PTP), vocal effort, and throat dryness in patients with chronic airway dryness.

Study design: Double-blind, within-subjects crossover design.

Methods: Eleven individuals with Primary Sjögren's Syndrome received a 15-minute laryngeal desiccation challenge (breathing dry air-<1% relative humidity-transorally), followed by nebulized isotonic saline or nebulized water treatments (3 mL) on 2 consecutive weeks. PTP, as well as self-perceived vocal effort, mouth, and throat dryness were assessed before and after the desiccation challenge, and at 5, 35, and 65 minutes after the nebulized treatment.

Results: The laryngeal desiccation challenge produced statistically significant increases in PTP, vocal effort, and mouth and throat dryness (P < 0.05). Nebulized saline produced greater-but not statistically significant-treatment effects than water. PTP was more correlated with throat dryness than vocal effort.

Conclusion: Patients with chronic airway dryness experienced phonatory changes following dry air exposure. Nebulized isotonic saline may offset this effect. Future research should explore dose-response relationships among dry air exposure, nebulized treatments, voice change, and self-perceived throat dryness.

Keywords: Hydration; PTP; Sjögren's Syndrome; laryngeal desiccation; throat dryness; vocal effort; vocal fold surface fluid.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Larynx / physiopathology*
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers
  • Phonation*
  • Sjogren's Syndrome / physiopathology*
  • Sjogren's Syndrome / therapy*
  • Sodium Chloride / administration & dosage*
  • Water / administration & dosage*


  • Water
  • Sodium Chloride