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hoarseness
- dysphonia (1)
- is an abnormality in voice quality
- is
also described as hoarseness .
- the patient may describe loss
of voice quality in many different ways
- the voice quality that may be
described and their differential diagnosis are as follows:
- breathy
- vocal
cord paralysis, abductor spasmodic dysphonia, functional dysphonia
- hoarse
- vocal cord lesion, muscle tension dysphonia, reflux laryngitis
- strained
- adductor spasmodic dysphonia, muscle tension dysphonia, reflux laryngitis
- low-pitched
- Reinke's oedema, vocal abuse, reflux laryngitis, vocal cord paralysis,
muscle tension dysphonia
- tremorous
- Parkinson's disease,
essential tremor of the head and neck, spasmodic dysphonia, muscle tension dysphonia
- vocal
fatigue
- muscle tension dysphonia, vocal cord paralysis, reflux laryngitis,
vocal abuse
- in most cases, hoarseness is
a relatively benign symptom of voice overuse or the result of laryngitis.
- however,
hoarseness that persists for more than three weeks must be considered to be a
laryngeal carcinoma until proven otherwise, and requires an urgent referral to
an ENT department.
- the causes of hoarseness include (1)
- neoplastic
- vocal cord polyps, vocal cord nodules, vocal cord granulomas, vocal cord
cyst, laryngeal papilloma, squamous cell cancer of the larynx
- inflammatory
- gastroesophageal reflux laryngitis, viral laryngitis, bacterial laryngitis,
tubercular or fungal laryngitis,allergic laryngitis
- neurologic
- vocal cord paralysis (unilateral),spasmodic dysphonia,movement disorder
(Parkinson's disease),essential tremor,cerebrovascular accident
- miscellaneous
- vocal abuse, vocal cord atrophy, vocal cord scarring, hypothyroidism
(myxedematous laryngitis), muscle tension dysphonia, Reinke's oedema,drugs
Reference: (1)
Rosen CA et al. Evaluating Hoarseness: Keeping Your Patient's Voice Healthy. American
Family Physicia 1998; 57(11)
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