Hoarseness

Hoarseness in a nigerian tertiary health facility: Prevalence, aetiology and predisposing factors

OBJECTIVES

To determine the prevalence, aetiology and predisposing factors in patients presenting with hoarseness to Usmanu Danfodiyo University Teaching Hospital, Sokoto.

METHODS

The study was a prospective, hospital-based study involving patients with hoarseness ≥7 years. Demographic characteristics and information on voice abuse, smoking, alcohol ingestion and gastroesophageal reflux disease (GERD) were taken. Participants had laryngeal endoscopy using a flexible nasopharyngolaryngoscopy to determine the cause of hoarseness.

RESULTS

A prevalence of 2.97% was obtained in the study, and the age range of participants was 7 to 78 years, with a male:female ratio of 1.3:1. The most common cause of hoarseness was laryngeal inflammation 38 (40.0%), followed by benign neoplasm 24 (25.3%) , malignancy 20 (21.1%) and trauma 10 (10.5%). Voice abuse, GERD and smoking were significant predisposing factors for benign neoplasm (χ² = 8.73; P = 0.0031), inflammation (χ² = 19.79; P < 0.0001) and malignancy of the larynx (χ² = 10.66; P = 0.0011), respectively.

CONCLUSION

The study showed that acute and chronic laryngeal infection and neoplasms (benign and malignant) of the larynx were the most common causes of hoarseness. Voice abuse, smoking and GERD were the commonest predisposing factors.

A Study of Clinicopathological Profile of Patients of Hoarseness of Voice Presenting to Tertiary Care hospital

Hoarseness is subjective term used to describe abnormal voice quality which may occur due to many causes because it is just a symptom. Proper knowledge and clinicopathological profile is important to treat the underlying pathology. This prospective study was carried out in 100 patients presented in Department of ENT, Gandhi Medical College, Bhopal from April 2013 to September 2014 with complaint of hoarseness of voice for more than 15 days. Objective of this study is to study incidence, duration and sex predilection for hoarseness of voice. Also to study different etiological and predisposing factors for hoarseness of voice. After taking detailed history of the patient, complete examination of ear, nose and throat has been carried out. Indirect laryngoscopy, direct laryngoscopy, FOFE is done. Any suspicious tissue is sent for histopathological evaluation. X-ray soft tissue neck and if required CT SCAN larynx is done. Out of 100 patients maximum were from 50 to 70 years age group. 89% were males while only 11% were females. Labourers (37%) and farmers (32%) were the major groups affected. Smoking habit found in 60% of patients and tobacco chewing in 33% of patients and both, also having. Most common cause for hoarseness was found out to be laryngeal neoplasms of which supraglottic growth being commonest (37%) in our study. Hoarseness of voice may be present due to various underlying pathologies. So proper diagnosis, through detailed history, clinical examination and investigations is warranted to find out the cause and starting treatment.

Clinical profile of hoarseness of voice

A study comprising of 110 cases of hoarseness was carried out in the department of otolaryngology-HNS, M.G.I.M.S., Sewagram between Jan. 1998 and Sept. 1999. Age of patients ranged between 6 to 71 years. Male to female ratio was 2∶1. Labourers constituted the single largest group of patients (36.36%). Rural to urban ratio was 3∶1. Duration of hoarseness ranged from 1 day to 5 years. Acute laryngitis was the commonest cause of hoarseness.

Diagnostic evaluation and management of hoarseness

Hoarseness is a common symptom that can result from a wide spectrum of underlying causes ranging from the common cold to a malignancy. A framework for diagnostic evaluation is presented based on categorizing the myriad of causes by how they interfere with the voice production mechanism. Triaging of cases by necessity or urgency of laryngoscopy is assisted by forming a global index of suspicion based on targeted history taking. Laryngoscopy is required in most cases to obtain a diagnosis for the hoarseness. Treatments commonly prescribed for hoarseness are critically examined in this article. To listen to audio clips of patients with different types of hoarseness, please visit our website, www.medical.theclinics.com.

Miller fisher syndrome presents as an acute voice change to hypernasal speech

The authors describe a 38-year-old man who presented with hypernasality, perioral and acroparesthesia, dyspnea, and dysphagia. Further evaluation revealed a diagnosis of Miller-Fisher syndrome (MFS). MFS is a variant of Guillain-Barré syndrome previously described in neurology and critical care journals; however, there is a paucity of work concerning this disease in the otolaryngology literature. An acute change in voice usually occurs secondary to inflammatory processes as seen after intubation and infection, but can occur as part of a more complex disease entity such as Guillain-Barré or Miller-Fisher syndrome. As such, clinicians should consider this in their evaluation of rhinolalia aperta.

Tubercular laryngitis: case series

INTRODUCTION

Tubercular laryngitis is a known entity since a long time but it's presentation, diagnosis and management has undergone a drastic makeover after the advent of chemotherapy in the form of ATT (Anti tubercular treatment), modernized diagnostic aids and early detection of lesions.

MATERIALS AND METHODS

This prospective study was conducted on 180 patients. Each patient were subjected to detailed history and thorough ENT and head neck examination including laryngeal examination by visualization of the vocal cords, possibly using indirect laryngoscopy,. exible naso-laryngoscopy or rigid laryngoscopy Results Tubercular laryngitis was clinically diagnosed by laryngeal endoscopy and diagnosis con. rmed by laryngeal biopsy.

CONCLUSION

All patients showed remarkable improvement with anti-tubercular treatment.