Hoarseness

Question 1

What is acute onset of hoarseness usually caused by?

Answer 1

Local inflammation of the larynx e.g. laryngitis

Question 2

What should always be considered in chronic progressive hoarseness?

Answer 2

Malignant process

Question 3

Important investigations in hoarse patient? (3)

Answer 3

Thyroid function tests
CXR
Direct laryngoscopy

Question 4

Which thyroid derangement causes hoarseness?

Answer 4

Hypothyroidism

Question 5

Extrinsic (i.e. outside the larynx) causes of hoarseness? (4)

Answer 5

Mediastinal masses
Hypothyroidism
Acid reflux
Post-nasal drip

Question 6

Intrinsic causes of hoarseness? (6)

Answer 6

Acute viral laryngitis
Vocal abuse
Nodules/polyps
Laryngeal cancer
Vocal cord paralysis
"Hysterical aphonia"

Question 7

Vocal cords are supplied by which nerve?

Answer 7

Vagus nerve via the recurrent laryngeal nerve

Question 8

Red flags for laryngeal carcinoma?

Answer 8

History of smoking
Hoarseness lasting longer than 3 weeks
Dysphagia
Neck lump
Persistent cough

Question 9

Aetiology of vocal cord palsy? (5)

Answer 9

Malignancy (30%)- [neck, thyroid, bronchus, oesophagus, nasopharynx]

Iatrogenic (25%) due to surgery

External trauma

Idiopathic

Neurological conditions e.g. MND, myasthenia