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{{SignSymptom infobox |
{{Infobox_Disease |
   Name        = Dysphonia |
   Name        = Dysphonia |
   ICD10      = {{ICD10|R|49||r|47}} |
   ICD10      = {{ICD10|R|49||r|47}} |
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{{CMG}}
{{CMG}}


{{SK}} hoarseness
 


==Overview==
==Overview==
'''Dysphonia''' is the medical term for hoarseness or other [[phonation]] disorders. It is considered much less severe than [[aphonia]].
'''Dysphonia''' is the medical term for hoarseness or other [[phonation]] disorders. It is considered much less severe than [[aphonia]]. Hoarseness can be a change in pitch, a rough sound of the voice, or an increased effort in speaking.
* '''Acute''' hoarseness has a sudden onset and lasts fewer than 2 weeks
* '''Chronic''' hoarseness lasts longer than 2 weeks


==Classification==
==Classificaiton of Dysphonia==
* Organic dysphonia
* Organic dysphonia
* Functional dysphonia
* Functional dysphonia
* [[Spasmodic dysphonia]]
*[[Spasmodic dysphonia]]
 
== Differential Diagnosis ==
 
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>


==Causes==
=== Acute ===
* [[List of voice disorders|Voice disorders]]
* Acute viral [[laryngitis]]
** [[Laryngitis]]
* [[Aortic aneurysm]]
** [[Chorditis]]
* [[Aortic dissection]]
** Vocal cord nodules
* [[Anaphylaxis]]
** [[Vocal fold cyst]]
* Bacterial [[tracheitis]] / [[laryngitis]]
** [[Reinke's Edema]] (Smoking)
* [[Cerebrovascular accident]] ([[CVA]])
** [[Laryngeal papillomatosis]]
* [[Chorditis]]
* [[Gastroesophageal reflux disease]]
* [[Croup]]
* [[Cancer of the larynx|Laryngeal Cancer]]
* Deep space face and neck infection
* [[Myasthenia gravis]]
* [[Epiglottitis]]
* Foreign body
* [[Head injury]]
* [[Laryngitis]]
* [[Laryngotracheobronchitis]]
* Overstress of vocal cords (speaking, shouting, singing, crying)
* [[Sinusitis]]
* [[Smoke irritation]]
* Surgery
* [[Trauma]]
* [[Upper Respiratory Infection]]
 
=== Chronic ===
* Aging
* [[Allergic Rhinitis]]
* [[Amyloidosis]]
* [[Amyotrophic Lateral Sclerosis]]
* [[Aortic aneurysm]]
* [[Bronchial carcinoma]]
* Bronchogenic tumor
* [[Chondromas]]
* Chronic cough, severe cold
* Chronic inhalation of chemical irritant agents (professional activity)
* Chronic [[sinusitis]]
* [[Drugs]]
* [[Edema]] of vocal cords
* [[Esophageal tumor]]
* Excessively dry and warm room coupled with low water intake
* Foreign body
* [[Gastroesophageal Reflux Disease]] ([[GERD]])
* [[Glomus jugulare tumor]]
* [[Guillain-Barre Syndrome]]
* Habitual aphonia
* [[Hemangioma]]
* [[Hemorrhage]] into [[vocal folds]]
* [[Hypothyroidism]]
* [[Hypothyroidism]]
* [[Hyperthyroidism]]
* [[Juvenile dermatomyositis]]
* [[Sinusitis]]
* [[Laryngeal papillomatosis]]
* Laryngocelesventricular prolapse
* [[Laryngeal carcinoma]]
* [[Left atrial enlargement]]
* [[Lipoma]]
* [[Lung cancer]]
* [[Lung cancer]]
* [[Juvenile dermatomyositis]]
* [[Menopause]]
* [[Multiple Sclerosis]]
* [[Muscular Dystrophy]]
* [[Myasthenia Gravis]]
* Neural [[tumor]]
* [[Neurofibroma]]
* [[Papillomas]]
* [[Parkinson's Disease]]
* Postsurgical
* Psychogenic [[aphonia]]
* [[Puberty]]
* [[Reinke's Edema]]
* Retention cysts
* [[Rheumatoid Arthritis]]
* [[Sarcoidosis]]
* Spastic dysphonia
* [[Squamous Cell Carcinoma]]
* [[Systemic Lupus Erythematosus]]
* [[Thyroid tumor]]
* Ventricular dysphonias
* [[Virilization]]
* [[Vocal cord]] [[nodules]]
* [[Vocal fold cyst]]
* [[Vocal cord paralysis]]
* [[Vocal cord]] polyps
* [[Wegener's Granulotomosis]]
 
== Diagnosis ==
 
== History and Symptoms ==
 
The following should be characterized as part of a full history:
* Onset
* Duration
* Prior history
* Exposure
* Medications
* Voice use
* Associated symptoms
* Medical history
* Surgical history
* Trauma
 
== Physical Examination ==
* Focus on neck, head, lung, thyroid and cardiac exams
* Evaluate voice quality
 
== Laboratory Findings ==
* Thyroid function tests to rule out [[hypothyroidism]]
 
=== X-Ray ===
* [[Chest X-ray]]
* Lateral neck X-ray
 
=== MRI and CT ===
* [[CT scan]] of sinuses
* [[CT scan]] of head and neck
 
=== Other Diagnostic Studies ===
* Upper gastrointestinal (GI) [[endoscopy]]
* Direct or fiber optic nasolaryngoscopy
* [[Biopsy]]
 
== Treatment ==
* '''Airway, breathing''' and '''circulation'''
* Voice rest
* Diet modification ([[GERD]])
* Stop smoking
* Wear protective clothing or masks (if hoarseness is due to exposure)
* Treat underlying etiologies
* Voice therapy
 
== Pharmacotherapy ==
 
=== Acute Pharmacotherapies ===
* [[Antibiotic]]s
* [[Oral steroids]]
* [[H2 blocker]]
* [[Proton pump inhibitors]]
* [[Intranasal steroids]]
* [[Antihistamines]]
 
== Surgery and Device Based Therapy ==
* Surgical intervention for abscesses, masses
* Cricothyrotomy or tracheostomy (to establish airway)


==See also==
==See also==
* [[Dysphasia]]
* [[Dysphasia]]
== References ==
{{reflist|2}}
{{Speech and voice symptoms and signs}}


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[[yi:הייזעריג]]
[[pl:Chrypka]]
[[pl:Chrypka]]
[[yi:הייזעריג]]


{{WH}}
[[Category:Otolaryngology]]
{{WS}}
[[Category:Signs and symptoms]]
[[Category:Needs patient information]]


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Revision as of 15:54, 19 August 2012

Dysphonia
ICD-10 R49
ICD-9 784.49

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

Dysphonia is the medical term for hoarseness or other phonation disorders. It is considered much less severe than aphonia. Hoarseness can be a change in pitch, a rough sound of the voice, or an increased effort in speaking.

  • Acute hoarseness has a sudden onset and lasts fewer than 2 weeks
  • Chronic hoarseness lasts longer than 2 weeks

Classificaiton of Dysphonia

Differential Diagnosis

In alphabetical order. [1] [2]

Acute

Chronic

Diagnosis

History and Symptoms

The following should be characterized as part of a full history:

  • Onset
  • Duration
  • Prior history
  • Exposure
  • Medications
  • Voice use
  • Associated symptoms
  • Medical history
  • Surgical history
  • Trauma

Physical Examination

  • Focus on neck, head, lung, thyroid and cardiac exams
  • Evaluate voice quality

Laboratory Findings

X-Ray

MRI and CT

Other Diagnostic Studies

  • Upper gastrointestinal (GI) endoscopy
  • Direct or fiber optic nasolaryngoscopy
  • Biopsy

Treatment

  • Airway, breathing and circulation
  • Voice rest
  • Diet modification (GERD)
  • Stop smoking
  • Wear protective clothing or masks (if hoarseness is due to exposure)
  • Treat underlying etiologies
  • Voice therapy

Pharmacotherapy

Acute Pharmacotherapies

Surgery and Device Based Therapy

  • Surgical intervention for abscesses, masses
  • Cricothyrotomy or tracheostomy (to establish airway)

See also


References

  1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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