Dysphonia: Difference between revisions
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{{ | {{Infobox_Disease | | ||
Name = Dysphonia | | Name = Dysphonia | | ||
ICD10 = {{ICD10|R|49||r|47}} | | ICD10 = {{ICD10|R|49||r|47}} | | ||
ICD9 = {{ICD9|784.49}} | | ICD9 = {{ICD9|784.49}} | | ||
}} | }} | ||
{{SI}} | {{SI}} | ||
{{CMG}} | |||
{{ | {{SK}} hoarseness | ||
==Overview== | ==Overview== | ||
'''Dysphonia''' is the medical term for hoarseness or other [[phonation]] disorders. It is considered much less severe than [[aphonia]]. | '''Dysphonia''' is the medical term for hoarseness or other [[phonation]] disorders. It is considered much less severe than [[aphonia]]. Hoarseness can be a change in pitch, a rough sound of the voice, or an increased effort in speaking. | ||
==Classificaiton of Dysphonia== | |||
===Based Upon Chronicity=== | |||
* '''Acute''' hoarseness has a sudden onset and lasts fewer than 2 weeks | |||
* '''Chronic''' hoarseness lasts longer than 2 weeks | |||
===Based Upon Pathophysiology=== | |||
* Organic dysphonia | |||
* Functional dysphonia | |||
*[[Spasmodic dysphonia]] | |||
== | == Causes == | ||
== | === Common Causes === | ||
* [[ | |||
** [[Laryngitis]] | *[[Aging]] | ||
** [[ | *[[Cold]] | ||
** Vocal cord nodules | *[[Foreign body in respiratory tract]] | ||
** [[Vocal fold cyst]] | *[[Hypothyroidism]] | ||
*[[Laryngitis]] | |||
** [[ | *[[Laryngeal cancer]] | ||
* [[Gastroesophageal | *[[Overstress of vocal cords (speaking, shouting, singing and crying)]] | ||
* [[ | *[[Sinusitis]] | ||
* [[ | *[[Tracheitis]] | ||
=== Causes by Organ System === | |||
{|style="width:80%; height:100px" border="1" | |||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |||
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aortic aneurysm]], [[Aortic dissection]], [[Left atrial enlargement]], [[Wegener's Granulotomosis]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Chemical / poisoning''' | |||
|bgcolor="Beige"| [[Smoke irritation]], [[Chronic inhalation of chemical irritant agents (professional activity)]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Dermatologic''' | |||
|bgcolor="Beige"| [[Lipoid proteinosis]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Drug Side Effect''' | |||
|bgcolor="Beige"| [[Axitinib]], [[Botulinum toxin]], [[Danazol]], [[Dornase alfa]], [[Gestrinone]], [[Ixabepilone]], [[Loratadine]], [[Naltrexone]], [[Oxcarbazepine]], [[Pramipexole]], [[Tobramycin]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Ear Nose Throat''' | |||
|bgcolor="Beige"| [[Elongated styloid process]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Endocrine''' | |||
|bgcolor="Beige"| [[Goitre]], [[Growth hormone secreting pituitary adenoma]], [[Hypothyroidism]], [[Parathyroid carcinoma]], [[Riedel thyroiditis]], [[Thyroid carcinoma]], [[Thyroid tumor]], [[Virilization]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Environmental''' | |||
|bgcolor="Beige"| [[Chronic inhalation of chemical irritant agents (professional activity)]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Gastroenterologic''' | |||
|bgcolor="Beige"| [[Esophageal tumor]], [[Gastroesophageal Reflux Disease (GERD)]], [[Oral submucous fibrosis]], [[Oropharyngeal cancer]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Genetic''' | |||
|bgcolor="Beige"| [[Diastrophic dwarfism]], [[Distal myopathy 2]], [[Lipoid proteinosis]], [[Muscular dystrophy]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Hematologic''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Iatrogenic''' | |||
|bgcolor="Beige"| [[Postsurgical]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Infectious Disease''' | |||
|bgcolor="Beige"| [[Acute viral laryngitis]], ,[[Bacterial tracheitis / laryngitis]] [[Chronic sinusitis]], [[Croup]], [[Deep space face and neck infection]], [[Epiglottitis]], [[Laryngitis]], [[Laryngotracheobronchitis]], [[Paracoccidioidomycosis]], [[Quinsy]], [[Sinusitis]], [[Tracheolaryngobronchitis]], [[Upper Respiratory Infection ]], [[Laryngeal papillomatosis]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Musculoskeletal / Ortho''' | |||
|bgcolor="Beige"| [[Diffuse idiopathic skeletal hyperostosis]], [[Muscular dystrophy]], [[Polymyositis]], [[Diastrophic dwarfism]], [[Distal myopathy 2]], [[Myasthenia gravis]], [[Juvenile dermatomyositis]], [[Rheumatoid arthritis]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Neurologic''' | |||
|bgcolor="Beige"| [[10th cranial nerve disorder]], [[12th cranial nerve disorder]], [[Acoustic neuroma]], [[Amyotrophic lateral sclerosis]], [[Bulbar palsy]], [[Cerebral palsy]], [[Cerebrovascular accident]], [[Guillain-Barre syndrome]], [[Laryngeal nerve palsy]], [[Motor neuron disease]], [[Multiple sclerosis]], [[Myasthenia gravis]], [[Neural tumor]], [[Parkinson's disease]], [[Posterior inferior cerebellar artery syndrome]], [[Spasmodic dysphonia]], [[Lipoid proteinosis]], [[Neurofibroma]], [[Vocal cord paralysis]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Nutritional / Metabolic''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Obstetric/Gynecologic''' | |||
|bgcolor="Beige"| [[Menopause]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Oncologic''' | |||
|bgcolor="Beige"| [[Bronchial carcinoma]], [[Bronchogenic tumor]], [[Chondromas]], [[Glomus jugulare tumor]], [[Neurofibroma]], [[Squamous cell carcinoma]], [[Thyroid carcinoma]], [[Thyroid tumor]], [[Growth hormone secreting pituitary adenoma]], [[Parathyroid carcinoma]], [[Esophageal tumor]], [[Acoustic neuroma]], [[Neural tumor]], [[Laryngeal carcinoma]], [[Lung cancer]], [[Oropharyngeal cancer]], [[Hemangioma]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Opthalmologic''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Overdose / Toxicity''' | |||
|bgcolor="Beige"| [[Axitinib]], [[Danazol]], [[Dornase alfa]], [[Gestrinone]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Psychiatric''' | |||
|bgcolor="Beige"| [[Habitual aphonia]], [[Psychogenic aphonia]], [[Spasmodic dysphonia]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Pulmonary''' | |||
|bgcolor="Beige"| [[Chorditis]], [[Edema of vocal cords]], [[Foreign body in respiratory tract]], [[Hemangioma]], [[Hemorrhage into vocal folds]], [[Laryngeal carcinoma]], [[Laryngeal granuloma]], [[Laryngeal papillomatosis]], [[Laryngocelesventricular prolapse]], [[Laryngomalacia]], [[Lipoma]], [[Lung cancer]], [[Nasal polyps]], [[Oropharyngeal cancer]], [[Papillomas]], [[Reinke's edema]], [[Retention cysts]], [[Spasmodic dysphonia]], [[Ventricular dysphonias]], [[Vocal cord nodules]], [[Vocal cord paralysis]], [[Vocal cord polyps]], [[Vocal fold cyst]], [[Acute viral laryngitis]], [[Bacterial tracheitis / laryngitis]], [[Chronic sinusitis]], [[Croup]], [[Epiglottitis]], [[Laryngitis]], [[Laryngotracheobronchitis]], [[Sinusitis]], [[Tracheolaryngobronchitis]], [[Upper Respiratory Infection ]], [[Bronchial carcinoma]], [[Bronchogenic tumor]], [[Squamous cell carcinoma]], [[Allergic rhinitis]], [[Chronic cough, severe cold]], [[Sarcoidosis]], [[Singer nodes]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Renal / Electrolyte''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Rheum / Immune / Allergy''' | |||
|bgcolor="Beige"| [[Allergic rhinitis]], [[Anaphylaxis]], [[Juvenile dermatomyositis]], [[Rheumatoid arthritis]], [[Rheumatoid disease]], [[Riedel thyroiditis]], [[Polymyositis]], [[Amyotrophic lateral sclerosis]], [[Guillain-Barre syndrome]], [[Multiple sclerosis]], [[Systemic lupus erythematosus]], [[Sarcoidosis]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Sexual''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Trauma''' | |||
|bgcolor="Beige"| [[Head injury]], [[Trauma]] | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Urologic''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Dental''' | |||
|bgcolor="Beige"| No underlying causes | |||
|- | |||
|-bgcolor="LightSteelBlue" | |||
| '''Miscellaneous''' | |||
|bgcolor="Beige"| [[Aging]], [[Amyloidosis]], [[Chronic cough, severe cold]], [[Excessively dry and warm room coupled with low water intake]], [[Overstress of vocal cords (speaking, shouting, singing, crying)]], [[Puberty]], [[Sarcoidosis]], [[Singer nodes]], [[Systemic lupus erythematosus]], [[Virilization]], [[Smoke irritation]], [[Menopause]], [[Foreign body in respiratory tract]] | |||
|- | |||
|} | |||
=== Causes in Alphabetical Order === | |||
{{MultiCol}} | |||
*[[10th cranial nerve disorder]] | |||
*[[12th cranial nerve disorder]] | |||
*[[Acoustic neuroma]] | |||
*[[Acute viral laryngitis]] | |||
*[[Aging]] | |||
*[[Allergic rhinitis]] | |||
*[[Amyloidosis]] | |||
*[[Amyotrophic lateral sclerosis]] | |||
*[[Anaphylaxis]] | |||
*[[Aortic aneurysm]] | |||
*[[Aortic dissection]] | |||
*[[Axitinib]] | |||
*[[Bacterial tracheitis / laryngitis]] | |||
*[[Botulinum toxin]] | |||
*[[Bronchial carcinoma]] | |||
*[[Bronchogenic tumor]] | |||
*[[Bulbar palsy]] | |||
*[[Cerebral palsy]] | |||
*[[Cerebrovascular accident]] | |||
*[[Chondromas]] | |||
*[[Chorditis]] | |||
*[[Chronic cough, severe cold]] | |||
*[[Chronic inhalation of chemical irritant agents (professional activity)]] | |||
*[[Chronic sinusitis]] | |||
*[[Croup]] | |||
*[[Danazol]] | |||
*[[Deep space face and neck infection]] | |||
*[[Diastrophic dwarfism]] | |||
*[[Diffuse idiopathic skeletal hyperostosis]] | |||
*[[Distal myopathy 2]] | |||
*[[Dornase alfa]] | |||
*[[Edema of vocal cords]] | |||
*[[Elongated styloid process]] | |||
*[[Epiglottitis]] | |||
*[[Esophageal tumor]] | |||
*[[Excessively dry and warm room coupled with low water intake]] | |||
*[[Fluticasone]] (aerosol) | |||
*[[Foreign body in respiratory tract]] | |||
*[[Gastroesophageal Reflux Disease (GERD)]] | |||
*[[Gestrinone]] | |||
*[[Glomus jugulare tumor]] | |||
*[[Goitre]] | |||
*[[Growth hormone secreting pituitary adenoma]] | |||
*[[Guillain-Barre syndrome]] | |||
*[[Habitual aphonia]] | |||
*[[Head injury]] | |||
*[[Hemangioma]] | |||
*[[Hemorrhage into vocal folds]] | |||
*[[Hypothyroidism]] | |||
*[[Ixabepilone]] | |||
*[[Juvenile dermatomyositis]] | |||
*[[Laryngeal carcinoma]] | |||
*[[Laryngeal granuloma]] | |||
*[[Laryngeal nerve palsy]] | |||
*[[Laryngeal papillomatosis]] | |||
*[[Laryngitis]] | |||
{{ColBreak}} | |||
*[[Laryngocelesventricular prolapse]] | |||
*[[Laryngomalacia]] | |||
*[[Laryngotracheobronchitis]] | |||
*[[Left atrial enlargement]] | |||
*[[Lipoid proteinosis]] | |||
*[[Lipoma]] | |||
*[[Loratadine]] | |||
*[[Lung cancer]] | |||
*[[Menopause]] | |||
*[[Motor neuron disease]] | |||
*[[Multiple sclerosis]] | |||
*[[Muscular dystrophy]] | |||
*[[Myasthenia gravis]] | |||
*[[Nasal polyps]] | |||
*[[Neural tumor]] | |||
*[[Neurofibroma]] | |||
*[[Oral submucous fibrosis]] | |||
*[[Oropharyngeal cancer]] | |||
*[[Overstress of vocal cords (speaking, shouting, singing, crying)]] | |||
*[[Papillomas]] | |||
*[[Paracoccidioidomycosis]] | |||
*[[Parathyroid carcinoma]] | |||
*[[Parkinson's disease]] | |||
*[[Polymyositis]] | |||
*[[Posterior inferior cerebellar artery syndrome]] | |||
*[[Postsurgical]] | |||
*[[Psychogenic aphonia]] | |||
*[[Puberty]] | |||
*[[Quinsy]] | |||
*[[Reinke's edema]] | |||
*[[Retention cysts]] | |||
*[[Rheumatoid arthritis]] | |||
*[[Rheumatoid disease]] | |||
*[[Riedel thyroiditis]] | |||
*[[Sarcoidosis]] | |||
*[[Singer nodes]] | |||
*[[Sinusitis]] | |||
*[[Smoke irritation]] | |||
*[[Spasmodic dysphonia]] | |||
*[[Squamous cell carcinoma]] | |||
*[[Systemic lupus erythematosus]] | |||
*[[Thyroid carcinoma]] | |||
*[[Thyroid tumor]] | |||
*[[Tracheolaryngobronchitis]] | |||
*[[Trauma]] | |||
*[[Upper Respiratory Infection ]] | |||
*[[Ventricular dysphonias]] | |||
*[[Virilization]] | |||
*[[Vocal cord nodules]] | |||
*[[Vocal cord paralysis]] | |||
*[[Vocal cord polyps]] | |||
*[[Vocal fold cyst]] | |||
*[[Wegener's Granulotomosis ]] | |||
{{EndMultiCol}} | |||
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | |||
=== Acute === | |||
* Acute viral [[laryngitis]] | |||
* [[Aortic aneurysm]] | |||
* [[Aortic dissection]] | |||
* [[Anaphylaxis]] | |||
* Bacterial [[tracheitis]] / [[laryngitis]] | |||
* [[Cerebrovascular accident]] ([[CVA]]) | |||
* [[Chorditis]] | |||
* [[Croup]] | |||
* Deep space face and neck infection | |||
* [[Epiglottitis]] | |||
* Foreign body | |||
* [[Head injury]] | |||
* [[Laryngitis]] | |||
* [[Laryngotracheobronchitis]] | |||
* Overstress of vocal cords (speaking, shouting, singing, crying) | |||
* [[Sinusitis]] | |||
* [[Smoke irritation]] | |||
* Surgery | |||
* [[Trauma]] | |||
* [[Upper Respiratory Infection]] | |||
=== Chronic === | |||
* Aging | |||
* [[Allergic Rhinitis]] | |||
* [[Amyloidosis]] | |||
* [[Amyotrophic Lateral Sclerosis]] | |||
* [[Aortic aneurysm]] | |||
* [[Bronchial carcinoma]] | |||
* Bronchogenic tumor | |||
* [[Chondromas]] | |||
* Chronic cough, severe cold | |||
* Chronic inhalation of chemical irritant agents (professional activity) | |||
* Chronic [[sinusitis]] | |||
* [[Drugs]] | |||
* [[Edema]] of vocal cords | |||
* [[Esophageal tumor]] | |||
* Excessively dry and warm room coupled with low water intake | |||
* Foreign body | |||
* [[Gastroesophageal Reflux Disease]] ([[GERD]]) | |||
* [[Glomus jugulare tumor]] | |||
* [[Guillain-Barre Syndrome]] | |||
* Habitual aphonia | |||
* [[Hemangioma]] | |||
* [[Hemorrhage]] into [[vocal folds]] | |||
* [[Hypothyroidism]] | * [[Hypothyroidism]] | ||
* [[ | * [[Juvenile dermatomyositis]] | ||
* [[ | * [[Laryngeal papillomatosis]] | ||
* Laryngocelesventricular prolapse | |||
* [[Laryngeal carcinoma]] | |||
* [[Left atrial enlargement]] | |||
* [[Lipoma]] | |||
* [[Lung cancer]] | * [[Lung cancer]] | ||
* [[ | * [[Menopause]] | ||
* [[Multiple Sclerosis]] | |||
* [[Muscular Dystrophy]] | |||
* [[Myasthenia Gravis]] | |||
* Neural [[tumor]] | |||
* [[Neurofibroma]] | |||
* [[Papillomas]] | |||
* [[Parkinson's Disease]] | |||
* Postsurgical | |||
* Psychogenic [[aphonia]] | |||
* [[Puberty]] | |||
* [[Reinke's Edema]] | |||
* Retention cysts | |||
* [[Rheumatoid Arthritis]] | |||
* [[Sarcoidosis]] | |||
* Spastic dysphonia | |||
* [[Squamous Cell Carcinoma]] | |||
* [[Systemic Lupus Erythematosus]] | |||
* [[Thyroid tumor]] | |||
* Ventricular dysphonias | |||
* [[Virilization]] | |||
* [[Vocal cord]] [[nodules]] | |||
* [[Vocal fold cyst]] | |||
* [[Vocal cord paralysis]] | |||
* [[Vocal cord]] polyps | |||
* [[Wegener's Granulotomosis]] | |||
== Diagnosis == | |||
== History and Symptoms == | |||
The following should be characterized as part of a full history: | |||
* Onset | |||
* Duration | |||
* Prior history | |||
* Exposure | |||
* Medications | |||
* Voice use | |||
* Associated symptoms | |||
* Medical history | |||
* Surgical history | |||
* Trauma | |||
== Physical Examination == | |||
* Focus on neck, head, lung, thyroid and cardiac exams | |||
* Evaluate voice quality | |||
== Laboratory Findings == | |||
* Thyroid function tests to rule out [[hypothyroidism]] | |||
=== X-Ray === | |||
* [[Chest X-ray]] | |||
* Lateral neck X-ray | |||
=== MRI and CT === | |||
* [[CT scan]] of sinuses | |||
* [[CT scan]] of head and neck | |||
=== Other Diagnostic Studies === | |||
* Upper gastrointestinal (GI) [[endoscopy]] | |||
* Direct or fiber optic nasolaryngoscopy | |||
* [[Biopsy]] | |||
== Treatment == | |||
* '''Airway, breathing''' and '''circulation''' | |||
* Voice rest | |||
* Diet modification ([[GERD]]) | |||
* Stop smoking | |||
* Wear protective clothing or masks (if hoarseness is due to exposure) | |||
* Treat underlying etiologies | |||
* Voice therapy | |||
== Pharmacotherapy == | |||
=== Acute Pharmacotherapies === | |||
* [[Antibiotic]]s | |||
* [[Oral steroids]] | |||
* [[H2 blocker]] | |||
* [[Proton pump inhibitors]] | |||
* [[Intranasal steroids]] | |||
* [[Antihistamines]] | |||
== | == Surgery and Device Based Therapy == | ||
* | * Surgical intervention for abscesses, masses | ||
* Cricothyrotomy or tracheostomy (to establish airway) | |||
== | == References == | ||
{{reflist|2}} | |||
{{Speech and voice symptoms and signs}} | |||
[[pl:Chrypka]] | [[pl:Chrypka]] | ||
[[Category:Otolaryngology]] | |||
[[Category:Needs patient information]] | |||
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Latest revision as of 14:45, 18 June 2015
Dysphonia | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: hoarseness
Overview
Dysphonia is the medical term for hoarseness or other phonation disorders. It is considered much less severe than aphonia. Hoarseness can be a change in pitch, a rough sound of the voice, or an increased effort in speaking.
Classificaiton of Dysphonia
Based Upon Chronicity
- Acute hoarseness has a sudden onset and lasts fewer than 2 weeks
- Chronic hoarseness lasts longer than 2 weeks
Based Upon Pathophysiology
- Organic dysphonia
- Functional dysphonia
- Spasmodic dysphonia
Causes
Common Causes
- Aging
- Cold
- Foreign body in respiratory tract
- Hypothyroidism
- Laryngitis
- Laryngeal cancer
- Overstress of vocal cords (speaking, shouting, singing and crying)
- Sinusitis
- Tracheitis
Causes by Organ System
Causes in Alphabetical Order
In alphabetical order. [1] [2]
Acute
- Acute viral laryngitis
- Aortic aneurysm
- Aortic dissection
- Anaphylaxis
- Bacterial tracheitis / laryngitis
- Cerebrovascular accident (CVA)
- Chorditis
- Croup
- Deep space face and neck infection
- Epiglottitis
- Foreign body
- Head injury
- Laryngitis
- Laryngotracheobronchitis
- Overstress of vocal cords (speaking, shouting, singing, crying)
- Sinusitis
- Smoke irritation
- Surgery
- Trauma
- Upper Respiratory Infection
Chronic
- Aging
- Allergic Rhinitis
- Amyloidosis
- Amyotrophic Lateral Sclerosis
- Aortic aneurysm
- Bronchial carcinoma
- Bronchogenic tumor
- Chondromas
- Chronic cough, severe cold
- Chronic inhalation of chemical irritant agents (professional activity)
- Chronic sinusitis
- Drugs
- Edema of vocal cords
- Esophageal tumor
- Excessively dry and warm room coupled with low water intake
- Foreign body
- Gastroesophageal Reflux Disease (GERD)
- Glomus jugulare tumor
- Guillain-Barre Syndrome
- Habitual aphonia
- Hemangioma
- Hemorrhage into vocal folds
- Hypothyroidism
- Juvenile dermatomyositis
- Laryngeal papillomatosis
- Laryngocelesventricular prolapse
- Laryngeal carcinoma
- Left atrial enlargement
- Lipoma
- Lung cancer
- Menopause
- Multiple Sclerosis
- Muscular Dystrophy
- Myasthenia Gravis
- Neural tumor
- Neurofibroma
- Papillomas
- Parkinson's Disease
- Postsurgical
- Psychogenic aphonia
- Puberty
- Reinke's Edema
- Retention cysts
- Rheumatoid Arthritis
- Sarcoidosis
- Spastic dysphonia
- Squamous Cell Carcinoma
- Systemic Lupus Erythematosus
- Thyroid tumor
- Ventricular dysphonias
- Virilization
- Vocal cord nodules
- Vocal fold cyst
- Vocal cord paralysis
- Vocal cord polyps
- Wegener's Granulotomosis
Diagnosis
History and Symptoms
The following should be characterized as part of a full history:
- Onset
- Duration
- Prior history
- Exposure
- Medications
- Voice use
- Associated symptoms
- Medical history
- Surgical history
- Trauma
Physical Examination
- Focus on neck, head, lung, thyroid and cardiac exams
- Evaluate voice quality
Laboratory Findings
- Thyroid function tests to rule out hypothyroidism
X-Ray
- Chest X-ray
- Lateral neck X-ray
MRI and CT
Other Diagnostic Studies
Treatment
- Airway, breathing and circulation
- Voice rest
- Diet modification (GERD)
- Stop smoking
- Wear protective clothing or masks (if hoarseness is due to exposure)
- Treat underlying etiologies
- Voice therapy
Pharmacotherapy
Acute Pharmacotherapies
Surgery and Device Based Therapy
- Surgical intervention for abscesses, masses
- Cricothyrotomy or tracheostomy (to establish airway)