Dysphonia: Difference between revisions

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==Background==
==Background==
*Also known as voice hoarseness, is any problem related to speaking or phonation
*Hoarseness or other abnormality of phonation
*Can be caused by myriad of disease processes affecting air stream into the larynx, or vocal cord vibrations
*Can indicate potential airway compromise
*Can resent as a variety of complaints, including shortness of breath, vocal tremor, altered pitch, or complete loss of voice


==Clinical Features==
==Causes/Differential Diagnosis==
 
===Emergent/urgent causes===
==Differential Diagnosis==
*[[Tracheal injury]], laryngeal airway trauma, [[Strangulation]]
*Posterior [[sternoclavicular dislocation]]
*Iatrogenic injury to recurrent laryngeal nerve: [[vagal nerve stimulator complication]], ENT, thyroid, or thoracic surgery
*[[Foreign body aspiration]]
*[[Caustic ingestion]], [[smoke inhalation injury]], [[blister chemical agents]]
*[[Angioedema]]
*[[Hypothyroidism]]/myxedema of vocal cords
*[[Neck mass]], squamous cell carcinoma, mediastinal adenopathy
*[[Aortic dissection]], [[nontraumatic thoracic aortic dissection]]
*[[Epiglottitis]], [[diphtheria]]
*[[Ludwig's angina]]
*[[Leishmaniasis]]
*[[Botulism]]
*[[Myasthenia gravis]]
*[[Acute flaccid myelitis]]
*[[Scorpion envenomation]], [[Elapidae]] bites
*[[Stroke]] (lateral medullary infarction)
*[[Parkinson's disease]]
===Non-emergent causes===
*[[Laryngitis]]
*[[GERD]]
*Post [[intubation]], [[laryngeal mask airway]], or [[supraglottic airway]]
*Voice overuse/misuse
*Vocal cord nodules
*Voice may sound abnormal to you, but be totally normal for that patient!


==Evaluation==
==Evaluation==
[[File:Dysphonia.png|thumb|Dysphonia Algorithm]]
*Evaluate airway!
*Testing/studies dependant on suspected underlying cause, based on history/exam


==Management==
==Management==
*Secure airway!
*Further management based on underlying cause


==Disposition==
==Disposition==
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[[Category:ENT]][[Category:Neurology]]
[[Category:ENT]][[Category:Neurology]] [[Category:Symptoms]]

Latest revision as of 04:13, 11 December 2016

Background

  • Hoarseness or other abnormality of phonation
  • Can indicate potential airway compromise

Causes/Differential Diagnosis

Emergent/urgent causes

Non-emergent causes

Evaluation

  • Evaluate airway!
  • Testing/studies dependant on suspected underlying cause, based on history/exam

Management

  • Secure airway!
  • Further management based on underlying cause

Disposition

See Also

External Links

References