Who Gets Dysphonia? Understanding the Dysphonia Patient Population With Insights From a Tertiary Academic Center

To characterize the demographic, clinical, and treatment-related features of patients presenting with dysphonia at a large academic medical center, with the aim of identifying trends that may inform targeted care strategies and reduce barriers to timely diagnosis and intervention.

Retrospective chart review.

We reviewed the electronic health records of 286 patients diagnosed with dysphonia and evaluated by laryngologists at the University of Nebraska Medical Center. Fifty-six variables related to demographics, socioeconomic factors, referral source, diagnosis, clinical findings, and treatment were extracted and entered into a deidentified database using REDCap. Data analysis was performed using SAS Studio.

The sample had a mean age of 57 years and was predominantly female (65%) and White (92%), with underrepresentation of racial minorities relative to the local population. Nearly half were non-professional voice users, with professional voice use reported in about one-quarter. Substance use varied, with a minority currently smoking or using cannabis, and most reporting light to moderate alcohol consumption. Common comorbidities included gastroesophageal reflux disease/laryngopharyngeal reflux (45%) and cardiovascular disease (42%). The majority underwent laryngoscopy and/or videostroboscopy, revealing muscle tension dysphonia (24%), vocal fold edema (17%), and vocal fold paralysis (11%) as the leading diagnoses. Voice therapy was the primary treatment modality (61%). Validated symptom scales indicated moderate average voice impairment with significant variability, and substantial subsets exhibited clinically relevant swallowing and reflux symptoms.

Patients with dysphonia are diverse in clinical presentation and medical history. A significant number present without a known inciting event, underscoring the complex and multifactorial etiology of dysphonia. Improved awareness and adherence to clinical guidelines may promote earlier diagnosis and optimize treatment outcomes. These findings highlight the heterogeneity of patients presenting with dysphonia and underscore the need for multidisciplinary assessment and tailored management.