<p>The use of combination inhalers is the mainstay of treatment of asthma/ACO overlap. However, it has several reported local and systemic side effects including dysphonia and laryngeal abnormalities. We aimed to analyze the subjective, objective, perceptual and aerodynamic characteristics of voice and combined it with videolaryngoscopy to evaluate structural abnormalities in patients with asthma. Using purposive sampling, 142 participants were enrolled, comprising 71 participants with asthma/Asthma COPD overlap on combination inhaler therapy for more than 6 months study group and 71 newly diagnosed cases of asthma/Asthma COPD overlap not started on combination inhalers as control group. Detailed history and drug history along with VLS, MDVP, GRBAS, VHI and aerodynamic parameters were evaluated in all participants. Dysphonia was reported by 24% of the cases, compared to 7% of controls. Among the patients, we discovered that 12.7% had laryngeal anomalies, compared to 2.1% of newly diagnosed individuals. Long-term users received higher ratings on the VHI scale’s functional, physical, and emotional dimensions as well as higher grades on all elements of the GRBAS scale than newly diagnosed participants. MDVP results indicated that long-term inhaler users had higher values for fundamental frequency and soft phonation index parameters We discovered that newly diagnosed individuals had greater Jitter and Shimmer levels, as well as mean NHR values than long-term inhaler users. Aerodynamic measurements revealed no statistically significant differences between the groups. Measures of dysphonia as well as laryngeal anbormalities were seen more commonly among the asthmatic patients on long term combination inhalers. This study helps establish the efficacy of computerized voice analysis as a cost effective assessment tool for early detection and evaluation of dysphonia in patients which allows the pulmonologist to appropriately alter the treatment.</p><p>Keywords- voice analysis, asthma, inhalers, MDVP</p>