COPD can affect vocal quality and production, both directly, associated with respiratory decline, and 
indirectly, as a side effect of medication and associated with concurrent symptoms. The voice 
problems can vary between patients depending on co-morbidities, prescribed medications and severity 
of COPD. These findings could be attributed to irritation of the laryngeal mucosa, or formation of 
deposits due to inhalation of steroids or as an effect of changed glottal mechanism and laryngeal 
airflow. Moreover, smoking is a major risk factor for changes in the conformation of the vocal folds, 
producing mainly glottic edema. The voice problems can vary between COPD patients depending on 
the severity of smoking, prescribed medications, method used to administer medication and disease 
severity. It is recommended in this study to stop smoking, limit usage of steroid and generalize a 
routine voice examination for COPD patients.