hoarseness of voice
TRANSCRIPT
HOARSENESS OF VOICE
DEFINITION
Hoarseness is defined as roughness of voice resulting from variations of periodicity and/or intensity of consecutive sound waves.
PRODUCTION OF NORMAL VOICE
Vocal cords should:
Be able to approximate properly with each other.
Have a proper size and stiffnessHave an ability to vibrate regularly in response to air column.
CONDITIONS CAUSING HOARSENESS
Loss of approximation as in vocal cord paralysis, fixation, tumor coming in between the vocal cords
Size of the cord which may increase in oedema of the cord or a tumor, or decrease in partial surgical excision or fibrosis
Stiffness, decreases in paralysis and increases in spastic dysphonia or fibrosis
AETIOLOGY
Causes:1. Inflammation Acute- acute laryngitis usually
following cold, influenze, exanthematous fever, laryngotracheobronchitis, diphtheria
Chronic- Specific: TB, Syphilis, scleroma, fungal infections
Non specific: Chronic laryngitis, atrophic laryngitis
2. Tumors- Benign: Papilloma, hemangioma, chondroma, fibroma, leukoplakia
Malignant: Carcinoma3. Tumor like masses- Vocal nodule,
Vocal polyp, angiofibroma, amyloid tumor, contact ulcer, laryngocoele
4. Trauma- Sub mucosal haemorrhage, laryngeal trauma, foreign bodies, intubation
PAPILLOMA
CARCINOMA LARYNX
VOCAL POLYP
4. Paralysis- paralysis of recurrent, superior laryngeal or both nerves
5. Fixation of cords- Arthritis, fixation of cricoaryetenoid joints
6. Congenital- Laryngeal web, cysts, laryngocoele
7. Miscellaneous- Dysphonia Plica Ventricularis, Mixoedema, Gout
8. Functional- Hysterical aphonia
LARYNGOCOELE
FIXATION OF CORDS
LARYNGEAL WEB
INVESTIGATIONS
1. History Mode of onset, duration of
illness, patient’s occupation, habits and associated complaints.
Any hoarseness persisting for more than 3 weeks deserves examination of larynx. Malignancy should be excluded in patients above 40 years.
2. Indirect Laryngoscopy Many of the local laryngeal
causes can be diagnosed
3. Examination of neck, chest, cardiovascular and neurological systems for laryngeal paralysis
INDIRECT LARYNGOSCOPY
4. Lab investigations and Radiological examination
5. Direct Laryngoscopy and Micro layngoscopy for detailed examination, biopsy of lesions and assessment of mobility of cricoaryetenoid joints
6. Bronchoscopy and Oesophagoscopy in cases of paralytic lesions of the cord to exclude malignancy
Thank you