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.