This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

GRBAS (grade, roughness, breathiness, asthenia, strain) scale

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

assessment of patients with laryngeal symptoms

Patients should be assessed for airway patency. Presence of stridor or respiratory distress should prompt emergency referral to a facility where airway support can be provided quickly if needed.

Following airway assessment, patient history should cover:

  • the nature and chronology of voice symptoms
  • exacerbating and relieving factors
  • patient's voice use and requirement
  • presence of associated red flag symptoms
  • life style factors e.g. smoking, diet, hydration
  • effect on quality of life and psychosocial wellbeing

Investigations commonly include:

  • general head and neck examination - oral cavity, oropharynx, and neck
  • assessment of the patient's voice - can be done through
    • a simple scale:
      • grade 1 (subjectively normal voice),
      • grade 2 (mild dysphonia),
      • grade 3 (moderate dysphonia),
      • grade 4 (severe dysphonia),
      • and grade 5 (aphonic) plus use of additional qualifiers used as necessary - for example, breathy, strained

    • GRBAS (grade, roughness, breathiness, asthenia, strain) scale
      • grades hoarseness, roughness, breathiness, aesthenia (weakness), and strain on a scale of 0-3
        • 0 = normal, 1 = mild degree, 2 = moderate degree, and 3 = high degree (1).

Reference:


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page