ASSESSMENT OF PATIENT WITH HOARSENESS
THOROUGH HISTORY-TAKING concerning the duration of symptoms, whether their appearance is acute or progressive, whether they are intermittent or persistent, their progressiveness and voice variations throughout the day. It is important to investigate whether there is a history of allergic rhinitis, previous operations that jeopardise the laryngeal nerve, injuries due to intubation or hypothyroidism. It is also significant to check whether there are accompanying symptoms such as pain, ear pain, cough, dysphagia, or aggravating routines and habits: use of alcohol or tobacco, voice abuse, profession.
, which includes testing the nose, pharynx and larynx with a flexible nasopharyngolaryngoscope, testing the vocal cords by stroboscopy, ear-hearing tests, neck palpation.
CAUSES OF HOARSENESS
These may be many, from a common cold to a malignancy.
Laryngitis due to gastroesophageal reflux, allergic laryngitis, sarcoidosis,
Wegener’s granulomatosis, rheumatoid arthritis, polychondritis
Viral laryngitis, bacterial laryngitis, tuberculous laryngitis, fungal laryngitis
VOCAL CORD PARESIS
Due to tumours, trauma, aortic arch aneurysms, after intubation, cerebrovascular diseases, postoperative or idiopathic.
SURGICAL PROCEDURES ENTAILING A RISK OF LARYNGEAL NERVE INJURY
Χειρουργικές επεμβάσεις στις καρωτίδες, Surgery on the carotids, cervical lymph node ablation, cardiac surgery, Surgery on the mediastinum, trachea, Thymectomy
INJURY OF THE LARYNX
Haematoma, swelling, fracture of the cartilage of the laryngeal skeleton, disarticulation
Reinke’s oedema, hypothyroidism, medications/cocaine, cysts, psychological causes
Vocal cord polyps, vocal cord nodules, papillomas, haemangioma, paraganglioma, schwannoma, chondroma, squamous cell carcinomas, other carcinomas and sarcomas, primary malignant lymphoma, metastatic tumours