Dysphonia: Difference between revisions
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==Background== | ==Background== | ||
* | *Hoarseness or other abnormality of phonation | ||
*Can | *Can indicate potential airway compromise | ||
== | ==Causes/Differential Diagnosis== | ||
===Emergent/urgent causes=== | |||
== | *[[Tracheal injury]], laryngeal airway injury, [[Strangulation]] | ||
*Posterior [[sternoclavicular dislocation]] | |||
*Iatrogenic trauma: [[intubation]], [[laryngeal mask airway]], [[vagal nerve stimulator complications]], 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]] | |||
*Voice overuse/misuse | |||
*Vocal cord nodules | |||
*Hoarse voice may just be normal for patient | |||
==Evaluation== | ==Evaluation== | ||
*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== | ||
Revision as of 04:05, 11 December 2016
Background
- Hoarseness or other abnormality of phonation
- Can indicate potential airway compromise
Causes/Differential Diagnosis
Emergent/urgent causes
- Tracheal injury, laryngeal airway injury, Strangulation
- Posterior sternoclavicular dislocation
- Iatrogenic trauma: intubation, laryngeal mask airway, vagal nerve stimulator complications, 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
- Voice overuse/misuse
- Vocal cord nodules
- Hoarse voice may just be normal for patient
Evaluation
- Evaluate airway!
- Testing/studies dependant on suspected underlying cause, based on history/exam
Management
- Secure airway!
- Further management based on underlying cause