Hoarseness Flashcards
What is hoarseness?
difficulty producing sound w change in voice pitch or quality
Why is it important that hoarseness >3 weeks is investigated?
chief and often only presentation of laryngeal carcinoma
What are important things to ask about in a hx?
GORD Dysphagia Smoking Stress Singing + shouting
What are causes of hoarseness?
- voice overuse
- smoking
- viral illness
- hypothyroidism
- GORD
- laryngeal cancer
- lung cancer
when should a suspected cancer pathway referral be made?
≥45yrs w:
- persistent unexplained hoarseness or
- unexplained lump in the neck
What investigations should u do?
Laryngoscopy
Slow motion videolaryngoboscopy/acoustic analysis
CXR - exclude apical lesions
What is reflux laryngitis?
irritation and swelling of the vocal folds due to the back flow of stomach fluids in the throat, associated w GORD
What is the treatment of reflux laryngitis?
PPIs
+/- surgical fundoplication
What are causes of laryngitis?
Viral
Strep/staph infection
GORD
Autoimmune e.g. RA
what are the sx of laryngitis
pain
hoarseness
fever
What is rx of laryngitis
Supportive
Penicillin V if necessary
What is Reinkes oedema
inflammation of vocal cords causing sac like appearance of fluid filled vocal cords causing voice to become deep and hoarse
What causes Reinkes oedema?
smoking
chronic voice abuse
What are functional disorders of speech articulation ?
aphonia
spasmodic dysphonia
childhood
give some causes of aphonia
psychogenic
disruption of recurrent laryngeal nerve (supplies most of laryngeal muscles) - either by surgery e.g. thyroidectomy or tumour
