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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • 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


(1) Rosen CA et al. Evaluating Hoarseness: Keeping Your Patient's Voice Healthy. American Family Physicia 1998; 57(11)

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