Hoarseness (Dysphonia) Flashcards
What is dysphonia?
Difficulty producing sound with change in voice pitch or quality. Normally due to viral URTI.
Why should you investigate hoarseness lasting more than 3 weeks?
Suspect laryngeal carcinoma (especially in smokers)
What are the causes of dysphonia?
- Laryngitis
- Vocal cord palsy
- GORD
- Reinke’s oedema
- Vocal cord nodules
- Laryngeal cancer
Which nerve is damaged in vocal cord palsy, what does it innervate, and where does it originate from?
- Recurrent laryngeal
- Intrinsic muscle of larynx except cricothyroid
- Originates from CN X
What is this a presentation of?
Weak ‘breathy’ voice with a weak cough, repeated coughing/aspiration, exertional dyspnoea.
Vocal cord palsy
What are the two main causes of vocal cord palsy?
- Cancers
2. Iatrogenic (after surgery)
How is a suspected vocal cord palsy investigated?
- Chest x-ray
- CT
- USS thyroid
- OGD
What is the management for GORD?
PPI, diet modification, weight loss
What is this a presentation of?
Women says she sounds like a man, smoker, deep and gruff voice.
Reinke’s oedema
What is the management for Reinke’s oedema?
Stop smoking, laser therapy may help
What is this a presentation of?
Singer who has trouble with technique, shouts and screams a lot, husky voice.
Vocal cord nodules
What is the management for vocal cord nodules?
Speech therapy, surgical excision
