DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20201292

Hoarseness of voice-prospective study: etiology, evaluation and treatment

Ila B. Upadhya, Dhaval C. Patel, Kartika R. Rao

Abstract


Background: Despite advances in medical technologies and improvement in diagnostic armamentarium in laryngology about 20% of cases remain undiagnosed until suspension laryngoscopy. The study was undertaken to identify etiological factors, type of lesions, age and sex distribution, sites of involvement, efficacy of different diagnostic and treatment modalities.

Methods: A prospective study of 45 cases of benign vocal cords lesions was carried out. Patients with hoarseness of voice for >3 weeks were investigated and treated with conservative management and surgery.  

Results: Hoarseness of voice presented within 6 months after onset of symptom. The common age of presentation was between 21 to 40 years, with male:female ratio of 1.25:1. Vocal abuse, laryngopharyngeal reflux disease (LPRD) and smoking, were the most common etiological factors. Housewives were most common group. Wide angled 700 telelaryngoscopy showed 80% accuracy rate. Suspension laryngoscopy showed 100% accuracy rate. Involvements of both the vocal cords were more common, vocal cord nodule being the commonest. 70% responded very well to conservative management.

Conclusions: Dysphonia is the most common presenting symptom having vocal cord lesion, non-professional voice user young females are most common sufferers with delay of 6 months in presenting to a laryngologist. Vocal abuse and LPRD are most common aetiologies. Telelaryngoscopy can diagnose up to 80% of them which is cost effective Outpatient Department procedure. 70% of them respond well to medical therapy and voice training. Identification of causative factor and management of them is mandatory for treatment and prevention of recurrence.


Keywords


Hoarseness, Voice, Vocal, Polyp, Nodule, Benign

Full Text:

PDF

References


Baitha S, Raizada RM, Singh A, Puttewar MP, Chaturvedi VN. Predisposing factors and aetiology of hoarseness of voice. Indian J Otolaryngol Head Neck Surg. 2004;56(3):186-90.

Batra K, Motwani G, Sagar P C.Functional voice disorders and their occurrence in 100 patients of hoarseness as seen on fiberoptic laryngoscopy. Indian journal of otolaryngology and head and neck surgery. 2004;56(21):91-5.

Ghosh S K, Chattopadhyay S, Bora H, Mukherjee P B. Micro laryngoscopic study of 100 cases of Hoarseness of voice. Indian J Otolaryngol Head Neck Surg. 2001;53(4):270-2.

Baitha S, Raizada RM, Singh AK, Puttewar MP, Chaturvedi VN. Clinical profile of Hoarseness of voice. Indian J Otolaryngol Head Neck Surg. 2002;54(1):14-8.

Banjara H, Mungutwar V, Singh D, Gupta A. Hoarseness of voice: A Retrospective study of 251 cases. Int J Phonosurg Laryngol. 2011;1(1):21-7.

Khurshid RS, Khan MA, Ahmad R. Clinical profile of hoarseness and its management options: A 2 year’s prospective study of 145 patients. Int J Phonosurgery Laryngol. 2012;2(1):23-9.

Chopra H, Kapoor M. Study of Benign Glottic lesions undergoing Microlaryngeal Surgery. Indian J Otolaryngol Head Neck Surg. 1997;49(3):276-9.

Goswami S, Patra T. A clinico-pathological study of Reinke’s Oedema. Indian J Otolaryngol Head Neck Surg. 2003;55(3):160-5.

Kuhn J, Toohill RJ, Ulualp SO, Kulpa J, Hofmann C, Arndorfer R, et al. Pharyngeal acid reflux events in patients with vocal cord nodules. Laryngoscope. 1998;108(8):1146-9.

Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. The Laryngoscope 1991;101(4 Pt 2 Suppl 53):1-78.

Neto JAM, Pinna BR, Neto JC, de Sá Pedroso JE. Comparison between telelaryngoscopy and suspension laryngoscopy in the diagnosis of benign vocal fold lesions. Rev Bras Otorrinolaringol. 2008;74(6):869-75.

Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness-causes and treatments. Dtsch Arztebl Int. 2015;112(19):329-37.

Johns MM. Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. Current Opinion Otolaryngol Head Neck Surg. 2003;11(6):456-61.

Mc Crory E. Voice therapy outcomes in vocal fold nodules: a retrospective audit. Int J Lang Commun Disord. 2001;36:19-24.

Karkos PD, McCormick M. The etiology of vocal fold nodules in adults. Current Opinion Otolaryngol Head Neck Surg. 2009;17(6):420-3.

Stajner-Katusic S, Horga D, Zrinski KV. A longitudinal study of voice before and after phonosurgery for removal of a polyp. Clin Linguist Phon. 2008;22(10-11):857-63.

Srirompotong S, Saeseow P, Vatanasapt P. Small vocal cord polyps: completely resolved with conservative treatment. Southeast Asian J Trop Med Public Health. 2004;35(1):169-71.

Nakagawa H, Miyamoto M, Kusuyama T, Mori Y, Fukuda H.. Resolution of vocal fold polyps with conservative treatment. J Voice. 2012;26(3):e107-10.

Schwartz SR, Cohen SM, Dailey SH, Rosenfeld RM, Deutsch ES, Gillespie MB, et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2009;141(Suppl 2):S1-S31.

Chadha NK, James A. Adjuvant antiviral therapy for recurrent respiratory papillomatosis. Cochrane Database Syst Rev. 2012;2:CD005053.

Nakamura A1, Iguchi H, Kusuki M, Yamane H, Matsuda M, Osako S. Laryngeal myxoma. Acta Oto-Laryngologica. 2008;128(1):110-2.