Complaints of hoarseness are very common. Hoarseness can have numerous different causes such as infections, benign abnormalities of the vocal cords due to incorrect use, malignant abnormalities of the vocal cords and larynx, and neurological problems. In all these cases, a thorough examination is warranted to assess the appearance of the vocal cords and how they behave during phonation.
What is your prediagnosis?
Prediagnosis
Congenital abnormalities
Obstruction
Inflammation
Tumours
Vascular problems
Trauma
Degenerative disorders involving the:
– epiglottis
– cricoid cartilage
– arytenoid cartilage
– false vocal cords
– true vocal cords
Allergy
During the history-taking consider the following:
- What is the precise nature of the complaint?
- How long has the hoarseness been present?
- Is it present constantly?
- Can any factors be identified that worsen or relieve the symptoms?
- Does the patient use their voice often, and if so, have they been properly trained for this?
- Does the patient have an infection of the upper airways or a sore throat?
- Does the patient have a fever?
- Does the patient smoke, and if so, how much?
- Does the patient have to spend a lot of time in smoky environments?
- How much alcohol does the patient consume?
- Do they have any allergies or hay fever?
- Is the patient generally unwell and/or losing weight?