Hoarse voice Flashcards
define stertor
caused by obstruction of airway above the larynx
low pitched snuffly sound
produced by vibrations of nasopharynx/pharynx/soft palate tissues
define stridor
air flow changes within the larynx, trachea or main bronchi
more ‘musical’
high pitched sound
can be insiratory, expiratory or biphasic
define wheeze
continuous coarse whistling sound
polyphonic
lower resp tract
define dysphonia
abnormal voice
define aphonia
loss of voice
define dysarthria
speech problem
differs from dysphonia!!
what is the primary concern if a patient develops a hoarse voice
laryngeal cancer
questions to ask in a history of hoarse voice
- nature of voice change
- duration
- preceding changes: infection, heartburn…
- associated symptoms: dysphagia, odynophagia
- systemic: weight loss, night sweats…
- RF: smoking, alcohol
features of examination in a hoarse voice presentation
tongue oral cavity palate tonsils cervical nodes thyroid flexible nasoendoscope for nasopharynx, pharynx, larynx, vocal cords, base of tongue
management of layngeal tumours:
small
large
small - radiotherapy or endoscopic laser surgery
large - laryngectomy
what is laryngectomy
partial / total removal of larynx
partial laryngectomy maintains normal airway but affects the voice, true or false
true
which is more common, total or partial laryngectomy
total
describe total laryngectomy
larynx is removed
end stoma is created and trachea is brought out to the midline fo the neck
pharynx is closed to oesophagus connects to mouth and nose
how can patients communicate post laryngectomy
written / technology
speech valve / electronic larynx speech / oesophageal speech
