Symptom finder - The causes of disorders of the voice ( hoarseness and others)
Symptom finder - The causes of disorders of the voice ( hoarseness and others)
Voice disorders are range from just a mild form of hoarseness to aphonia. There are few causes of disorders in projection of voices.
Autoimmune disease such as myasthenia gravis and infective causes such as laryngitis may contributes to voice disorders. Traumatic causes such as excessive use of voice or blunt trauma may also cause disorders of the voice. Neoplastic causes of voice disorders are laryngeal papilloma as well as laryngeal carcinoma. Early stages of laryngeal carcinoma is easily treated but late stages carry a poor prognosis especially when metastases has occurred. Psychogenic factor may also cause voice disorders. Voice disorders such as hoarseness are also associated with recurrent laryngeal nerve palsy. The causes of recurrent laryngeal nerve palsy are thoracic aortic aneurysm, esophageal carcinoma, post operative ( thyroid surgery, parathyroid surgery or thoracic surgery), bronchial carcinoma and goitre.
The present of goiter and recurrent laryngeal nerve palsy are associated with malignancy of the thyroid gland. Lung carcinoma and esophageal carcinoma may lead to infiltration of the tumor to the recurrent laryngeal nerve. Thoracic aneurysm’s patient may complain of hoarseness of the voice. Recurrent laryngeal nerve or vagus nerve injuries are associated with previous cases of thoracic or thyroid surgeries.
Progressive deterioration of the voice is associated with tumor while transient deterioration of the quality of the voice is due to excessive use of voice and infection. Recurrent laryngeal nerve palsy may present with sustained hoarseness.
Myasthenia gravis may present with muscle fatigue, diplopia, ptosis and nasal voices. Acute laryngitis will be accompany by pharyngitis /sore throat. Dysphagia which is progressive and rapid in nature is associated with esophageal carcinoma. Dysphagia and referred pain to the ear is associated with laryngeal carcinoma. Functional causes of voice abnormalities are associated with impairment of voice intensity, normal coughing and bizarre symptoms. Hoarseness may occur due to excessive shouting , excessive use of voice by singer and smoking. Influenza viral infection may lead to acute laryngitis. Fracture of the larynx may lead to hoarseness and it is a sign of precarious airway. Blunt trauma to the larynx may also cause hoarseness.
Larynx need to be inspected by using indirect laryngoscopy, headlamp and mirror or under local anesthetic using flexible fiberoptic laryngoscopy. Paralysis of unilateral vocal cord may be an evident of recurrent laryngeal nerve palsy. Supraglottic carcinoma and vocal cord papilloma are visible by inspection. Acute laryngitis is characterized by erythematous dry larynx. Esophageal carcinoma may present as palpable cervical lymphadenopathy . The present of goiter is detected by full examination of the neck. Bronchogenic carcinoma is characterized by chest’s sign such as pleural effusion and lobar collapse.
Voice disorders are range from just a mild form of hoarseness to aphonia. There are few causes of disorders in projection of voices.
Autoimmune disease such as myasthenia gravis and infective causes such as laryngitis may contributes to voice disorders. Traumatic causes such as excessive use of voice or blunt trauma may also cause disorders of the voice. Neoplastic causes of voice disorders are laryngeal papilloma as well as laryngeal carcinoma. Early stages of laryngeal carcinoma is easily treated but late stages carry a poor prognosis especially when metastases has occurred. Psychogenic factor may also cause voice disorders. Voice disorders such as hoarseness are also associated with recurrent laryngeal nerve palsy. The causes of recurrent laryngeal nerve palsy are thoracic aortic aneurysm, esophageal carcinoma, post operative ( thyroid surgery, parathyroid surgery or thoracic surgery), bronchial carcinoma and goitre.
The present of goiter and recurrent laryngeal nerve palsy are associated with malignancy of the thyroid gland. Lung carcinoma and esophageal carcinoma may lead to infiltration of the tumor to the recurrent laryngeal nerve. Thoracic aneurysm’s patient may complain of hoarseness of the voice. Recurrent laryngeal nerve or vagus nerve injuries are associated with previous cases of thoracic or thyroid surgeries.
Progressive deterioration of the voice is associated with tumor while transient deterioration of the quality of the voice is due to excessive use of voice and infection. Recurrent laryngeal nerve palsy may present with sustained hoarseness.
Myasthenia gravis may present with muscle fatigue, diplopia, ptosis and nasal voices. Acute laryngitis will be accompany by pharyngitis /sore throat. Dysphagia which is progressive and rapid in nature is associated with esophageal carcinoma. Dysphagia and referred pain to the ear is associated with laryngeal carcinoma. Functional causes of voice abnormalities are associated with impairment of voice intensity, normal coughing and bizarre symptoms. Hoarseness may occur due to excessive shouting , excessive use of voice by singer and smoking. Influenza viral infection may lead to acute laryngitis. Fracture of the larynx may lead to hoarseness and it is a sign of precarious airway. Blunt trauma to the larynx may also cause hoarseness.
Larynx need to be inspected by using indirect laryngoscopy, headlamp and mirror or under local anesthetic using flexible fiberoptic laryngoscopy. Paralysis of unilateral vocal cord may be an evident of recurrent laryngeal nerve palsy. Supraglottic carcinoma and vocal cord papilloma are visible by inspection. Acute laryngitis is characterized by erythematous dry larynx. Esophageal carcinoma may present as palpable cervical lymphadenopathy . The present of goiter is detected by full examination of the neck. Bronchogenic carcinoma is characterized by chest’s sign such as pleural effusion and lobar collapse.
The investigations require are full blood count, chest x ray , CT scan of the thorax, CT scan of the neck, ESR, endoscopy, arch aortography, Tensilon test and FNAC.
Full blood count may reveal raise white cell count due to laryngitis. Chest x ray may reveal bronchial carcinoma, thoracic aneurysm or widen mediastinum. CT scan of the thorax may detect the present of thyroid carcinoma and laryngeal carcinoma. Raised ESR is associated with carcinoma and laryngitis. Endoscopy may detect esophageal carcinoma. Thoracic aneurysm may be detected with arch aortography. Tensilon test is useful for myasthenia gravis and FNAC for thyroid carcinoma.
Full blood count may reveal raise white cell count due to laryngitis. Chest x ray may reveal bronchial carcinoma, thoracic aneurysm or widen mediastinum. CT scan of the thorax may detect the present of thyroid carcinoma and laryngeal carcinoma. Raised ESR is associated with carcinoma and laryngitis. Endoscopy may detect esophageal carcinoma. Thoracic aneurysm may be detected with arch aortography. Tensilon test is useful for myasthenia gravis and FNAC for thyroid carcinoma.