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 stiffness
Have an ability to vibrate
regularly in response to air
column.

CONDITIONS CAUSING
HOARSENESS

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
Loss

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: Carcinoma
3. 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,

patients 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