Hoarseness

Diagnosis

In the evaluation of hoarseness, a specialist in otolaryngology, or ENT (ears, nose, and throat), follows a systematic approach. Here’s an overview:

• History taking: The ENT will initiate the assessment by obtaining pertinent information, including:
  • Duration of hoarseness.
  • Onset (sudden or gradual).
  • History of recent upper respiratory infections.
  • Presence of associated symptoms.
  • Smoking history, including duration.
  • Alcohol consumption.
• Physical examination: A thorough examination of the head and neck region will be conducted to identify any palpable abnormalities or masses.
• Voice evaluation: The specialist will assess the quality of your voice for any anomalies or irregularities.
• Laryngoscopy: Utilizing a laryngoscope, a specialized instrument, the ENT will perform a direct examination of the vocal cords. This instrument is introduced through the nostrils to provide a detailed view of the larynx.
• Diagnostic test:
  • Biopsy: In cases of concern, a tissue biopsy may be recommended to obtain a definitive diagnosis.
  • Imaging: Computed tomography (CT) scans or magnetic resonance imaging (MRI) may be ordered to further investigate the condition.

These comprehensive steps enable the ENT specialist to establish an accurate diagnosis and formulate an appropriate treatment plan for the patient’s hoarseness.

Treatment

The treatment for hoarseness depends on its underlying cause:

• Overuse of voice: Rest your voice and drink plenty of water.
• Cold or sinus infection: Allow the cold to run its course or use over-the-counter cold medicines.
• Laryngitis: Consult your healthcare provider; you may need antibiotics or corticosteroids.
• Gastroesophageal reflux (GERD): Treat with antacids or proton pump inhibitors.
• Vocal fold hemorrhage: Rest your voice.
• Neurological diseases/disorders: Personalized treatments for specific conditions.
• Vocal nodules, cysts, polyps: Dietary changes and voice therapy. Surgery may be considered.
• Vocal fold paralysis: ENT procedure or surgery as needed.
• Laryngeal cancer: Options include radiation, chemotherapy, immunotherapy, and surgery.
• Recurrent respiratory papillomatosis: Removal of growths to clear airways.
• Muscle tension dysphonia: Observation or voice therapy with a speech-language pathologist.

If hoarseness is a recurring issue due to excessive voice use, consider voice therapy with a speech-language pathologist to learn voice-saving techniques and exercises.