THROAT – Hoarseness

What is hoarseness of voice?

It is a breathy and harsh voice resulting due to an abnormality in the larynx.

What are the causes of hoarseness of voice?
Congenital:

●  Laryngeal web

●  Laryngeal cysts

1. Acquired: Neoplastic:
Benign

●   Pharyngeal diverticula: Overflow of contents into larynx causes chronic irritation of the larynx and laryngitis

●   Juvenile Laryngeal Papillomatosis

●   Haemangioma

●   Cysts of vocal cords

Malignant:

●   Bronchial carcinoma: The malignancy commonly involves the mediastinum and obstructs the superior vena cava causing recurrent laryngeal nerve palsy.

●   Carcinoma of vocal cords and larynx

●   Thyroid carcinoma

●   Oesophageal malignancies involving the recurrent laryngeal nerve

III. Inflammatory:

●   Acute laryngitis

●   Chronic laryngitis.

●   Atrophic laryngitis: It is a rare condition characterized by atrophic changes in the respiratory mucosa with mucous-producing glands

●   Tuberculosis

●   Singers nodules

●   Diphtheria

●   Leprosy

Traumatic:

●  Intubation trauma

●   Inhalation of foreign body

●   Accidents

●   Strangulation

Miscellaneous:

●  Vocal cord palsy

●   Laryngeal edema

●   Gout

●   Laryngocele

●  Functional aphonia

●   Reflux oesophagitis

What investigations are required for diagnosing the cause of hoarseness of voice?

●  Blood: Routine blood investigations

●  Test for diabetes, syphilis (VDRL)

●   Thyroid function tests

●  Indirect laryngoscopy in OPD

●   Direct laryngoscopy to confirm findings

●  Fiber-optic laryngoscopy helps to check the larynx closely

●   Panendoscopy

● CT Scan may be useful in cases of malignancy

●   Allergy Test

●   Voice analysis by a Voice therapist gives a perfect picture of the voice quality

What is the treatment for hoarseness of voice?

●  History: To know of any trauma and progress of the hoarseness

●  ENT examination to know the cause of the hoarseness

Medical line of treatment:

●  Voice rest

●  Steam inhalation

●  Antibiotics to control infection

●  Anti-inflammatory medicines

●  Low dose steroids in a tapering dose.

●  Vocal Hygiene

●  Voice Therapy

If there is improvement within 1 week:

●  Voice Hygiene

●  Voice Therapy

If there is no improvement for 2 weeks: Microlaryngoscopy with laser surgery.