hoarseness
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Etiology
- laryngitis (also see laryngitis)
- neoplasm
- squamous cell carcinoma
- head & neck cancer
- associated with alcohol & tobacco
- benign neoplasm on the vocal cord
- laryngeal wart
- esophageal cancer with recurrent laryngeal nerve involvement
- squamous cell carcinoma
- gastroesophageal reflux (GERD)
- sinusitis with a purulent post nasal drip
- pulmonary hypertension
- hypothyroidism
- relapsing polychondritis
- anaphylaxis
- leprosy
- Wallenberg's syndrome
- vocal cord dysfunction - overuse of the voice
- pharmaceutical agents
- temporal arteritis
- pemphigus vulgaris
- periodontal disease
- polycythemia
History
Clinical manifestations
- acute onset - infection, overuse
- chronic - malignancy
- dysphonia
Diagnostic procedures
- laryngoscopy, or refer ENT, when dysphonia fails to resolve or improve within 4 weeks[4][5]
Radiology
- computed tomography or MRI not indicated prior to laryngoscopy
Management
- treat underlying cause
- do not treat for GERD prior to laryngoscopy
- do not treat with antibiotics
- botulinum toxin injections for spasmodic dysphonia or laryngeal dystonia
- surgery for malignancy, symptomatic benign vocal cord lesions[4][5]
- voice therapy[3]
More general terms
Additional terms
References
- ↑ Kaiser Permanente Clinical Practice Guidelines
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 3.0 3.1 MacKenzie K, Millar A, Wilson JA, Sellars C, Deary IJ. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial. BMJ. 2001 Sep 22;323(7314):658-61. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11566828 Free PMC Article
- ↑ 4.0 4.1 4.2 Stachler RJ, Francis DO, Schwartz SR et al Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018 Mar;158(1_suppl):S1-S42. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29494321 <Internet> http://journals.sagepub.com/doi/full/10.1177/0194599817751030
Stachler RJ, Francis DO, Schwartz SR Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary. Otolaryngol Head Neck Surg. 2018 Mar;158(3):409-426. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29494316 - ↑ 5.0 5.1 5.2 Phillips D. Guideline Updates Recommendations for Persistent Hoarseness. Medscape Medical News. WebMD Inc. March 6, 2018. https://www.medscape.com/viewarticle/893459
- ↑ Syed I, Daniels E, Bleach NR. Hoarse voice in adults: an evidence-based approach to the 12 minute consultation. Clin Otolaryngol. 2009 Feb;34(1):54-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19260886 Review.
- ↑ Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness-causes and treatments. Dtsch Arztebl Int. 2015 May 8;112(19):329-37. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26043420 PMCID: PMC4458789 Free PMC article. Review.