Hoarseness & Dysphonia

Question 0

Causes of Dysphonia

Answer 0

Laryngitis, benign neoplasm (papilloma, haemangioma)
Malignancy (SCC, thyroid tumour)
Neurological –> CVA, MS, recurrent laryngeal nerve palsy, MND
Mechanical–> singer’s nodules, vocal cord polyps/cysts

Question 1

Examination for hoarseness/Dysphonia

Answer 1

Laryngeal mirror –> can trigger gag reflex
Fibreoptic nasolaryngoscope –> expansive and poor resolution
Video laryngostroboscopy –> slow mo video but expensive

Question 2

Symptoms of laryngitis

Answer 2

URTI
Short in duration
Aphonia
Sore throat

Question 3

Causes of Benign vocal fold lesions

Answer 3

Polyps
Nodules
Cysts
Granulomas
Renike's oedema

Question 4

Reinke’s oedema

Answer 4

Polyploid degeneration
Fluid collection in the superficial laminate propria of the vocal cords –> leads to low-pitched, husky voices
Can be caused by–> smoking, reflux, hypothryoidism and chronic voice abuse

Question 5

Vocal cord polyps

Answer 5

Generally from trauma or overuse

Middle portion of musculo-membranous region

Question 6

Vocal cord nodules

Answer 6

Fibrovascular
Vocal cord abuse
Treat with vocal rehab

Question 7

Vocal cord cysts

Answer 7

Arise in the superficial lamina propria
Most from obstructed mucus ducts
Must be resected, and SLP doesn’t regenerate

Question 8

Vocal cord granulomas

Answer 8

A hypertrophic inflammatory reaction –> traumatic mucosal disruption
Commonly in the artenoids
Can be caused by reflux or intubation

Question 10

Vocal cord papilloapmatosis

Answer 10

Papillomas on the cords
Linked to HPV 6 and 11
Resect but be careful of the superficial lamina propria

Question 11

Vocal Cord Paralysis

Answer 11

1/4 iatrogenic, 1/3 malignant, rest can be infectious or idiopathic

Question 12

Laryngeal cancer

Answer 12

Kills more people than cervical cancer, 1% of total male cancers –> most common head/neck
peak incidence 55-65. presents with: hoarseness, stidor, dysphagia,