Hoarseness

Also known as dysphonia.

Dysphonia is characterized by altered vocal quality, pitch, loudness, or effort.

Dysphonia can impair social and professional communications.

Dysphonia can impair quality-of-life by affecting emotional, physical, social, and work related functions.

Has a lifetime prevalence of 29.9% in adults and 65 years or younger (Roy N et al).
Only 6% of individuals seek treatment for dysphonia.

More common in women, children and older adults.

Higher prevalence in telemarketers, aerobic instructors and teachers.

Female to male ratio, 3:2.

Dystonia occurs in higher prevalence in patients who use their voice extensively for their profession.

Estimated 7% of the general population misses at least one day of work because of voice problems and represents approximately $2.5 billion in annual lost productivity in the US.

Warfarin, thrombolytic agents, and phoshodiesterase-5 inhibitors can induce dysphonia by causing vocal fold hematomas.

Antihistamines, diuretics, and anti-cholinergic drugs can dry laryngopharyngeal mucosa and cause dysphonia.

Danazol and testosterone can alter sex hormone production or use and cause dysphonia.

Inhaled corticosteroids can cause dysphonia via a myopathy or mucosal effect on the laryngopharynx.

In the absence of an upper respiratory infection persistent hoarseness for more than 2 weeks requires a complete evaluation.

Common symptom with a wide range of causes including:irritants such as tobacco, alcohol, inhaled steroids, GERD, voice overuse, allergies, infections, malignancies, neuromuscular disorders, vocal cord injury, and recurrent laryngeal nerve injury.

Evaluation requires adequate history of process, assessment of voice quality, and head and neck physical examination.

Unexplained hoarseness for more than 2 weeks requires laryngeal evaluation by direct or indirect laryngoscopy.

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