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Hoarseness-causes and treatments
Rudolf Reiter1, Thomas Karl Hoffmann, Anja Pickhard
1Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Department of Otorhinolaryngology, University Hospital Klinikum rechts der Isar, Technische Universität München, Munich.
Hoarseness (dysphonia) has many causes, including laryngitis and vocal cord issues. Effective treatments include voice therapy, surgery, and reflux management, but empirical antibiotics are not recommended.
Area of Science:
- Otolaryngology
- Primary Care Medicine
Background:
- Hoarseness (dysphonia) accounts for approximately 1% of primary care consultations.
- Causes range from self-limiting laryngitis to malignant vocal cord tumors.
Purpose of the Study:
- To review the causes, diagnosis, and treatment of hoarseness.
- To provide evidence-based recommendations for managing dysphonia.
Main Methods:
- Literature search of PubMed using terms 'hoarseness,' 'hoarse voice,' and 'dysphonia.'
- Inclusion of guidelines from the American Academy of Otolaryngology -Head and Neck Surgery.
- Review of relevant Cochrane reviews.
Main Results:
- Common causes include acute (42.1%) and chronic laryngitis (9.7%), functional vocal disturbances (30%), benign (10.7-31%) and malignant tumors (2.2-3%), and neurogenic issues (2.8-8%).
- Voice therapy is effective for functional and organic vocal disturbances (Level 1a evidence).
- Surgery is indicated for tumors and inadequate vocal cord closure; pharmacologic treatment is effective for chronic laryngitis with reflux.
Conclusions:
- Voice therapy, vocal cord surgery, and targeted drug therapy are evidence-based treatments for hoarseness.
- Laryngoscopy is recommended for immediate evaluation in patients with risk factors, particularly smokers.
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