Hoarseness is defined as a roughness of the voice caused by irregular vibration of the vocal cords. The vocal cords must approximate properly, have the proper size and stiffness, and vibrate regularly in response to airflow in order to produce normal voice. Conditions that can cause hoarseness include loss of approximation or changes in size or stiffness of the vocal cords due to issues like paralysis, tumors, edema, or fibrosis. Hoarseness can be caused by inflammation, tumors, trauma, paralysis, fixation of the cords, congenital issues, or miscellaneous conditions like dysphonia or thyroid problems. Investigating hoarseness involves taking a medical history, examining the neck and chest, and directly examining the larynx using laryngoscopy

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

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