HOARSENESS OF VOICE IN DETAIL....

1. HOARSENESS OF VOICE
PRESENTED BY:-
K.AGASYA RAJ

2. DEFINITION
Hoarseness is defined as roughness of
voice resulting from variations of
periodicity and/or intensity of
consecutive sound waves.

3. 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.

4. CONDITIONS CAUSING
HOARSENESS
Loss 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

5. AETIOLOGY
 1. Inflammation
◦Acute- acute laryngitis usually following
cold, influenza, exanthematous fever,
laryngotracheobronchitis, diphtheria
◦Chronic- Specific: TB, Syphilis, scleroma,
fungal infections Non specific: Chronic
laryngitis, atrophic laryngitis

6. AETIOLOGY
2.Tumors-
◦Benign: Papilloma, hemangioma,
chondroma, fibroma, leukoplakia
◦Malignant: Carcinoma

7. AETIOLOGY
3.Tumor like masses- Vocal nodule,
Vocal polyp, angiofibroma, amyloid
tumor, contact ulcer, laryngocoele

8. AETIOLOGY
4.Trauma- Sub mucosal haemorrhage,
laryngeal trauma, foreign bodies,
intubation

9. AETIOLOGY
5.Paralysis- paralysis of recurrent,
superior laryngeal or both nerves
6.Fixation of cords- Arthritis, fixation of
cricoaryetenoid joints
7.Congenital- Laryngeal web, cysts,
laryngocoele

10. AETIOLOGY
8.Miscellaneous- Dysphonia Plica
Ventricularis, Mixoedema, Gout
9.Functional- Hysterical aphonia

11. INVESTIGATIONS
1. History Mode of onset, duration of
illness, patient’s 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.

13. 3. Examination of neck, chest,
cardiovascular and neurological systems
for laryngeal paralysis
4. Lab investigations and Radiological
examination

14. 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

15. THANK YOU