Hoarseness: When to observe and when to refer

Ellen L. Ferraro; Rebecca Chota Nelson; Paul C. Bryson

doi:10.3949/ccjm.90a.23010

ABSTRACT

The terms hoarseness and dysphonia are used interchangeably, and both describe a type of altered vocal quality affecting one-third of patients. While hoarseness may be secondary to benign conditions such as reflux or viral laryngitis, it may suggest benign or malignant vocal-fold pathology. It is important for caregivers to know how to evaluate, treat, and when to refer patients for direct visualization via laryngoscopy. In this article, we review basic laryngeal anatomy and function, symptoms of vocal-fold pathology, and current guidelines from the American Academy of Otolaryngology–Head and Neck Surgery on the diagnosis and treatment of dysphonia, including patient referral.

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Ellen L. Ferraro, MD⇑

Department of Otolaryngology, Cleveland Clinic, Cleveland, OH

Address:
Ellen L. Ferraro, MD, Department of Otolaryngology, A71, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; ferrare{at}ccf.org

28493-rebecca-chota-nelsonRebecca Chota Nelson, MD

Head and Neck Institute, Cleveland Clinic, Cleveland, OH; Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH

14474-paul-c-brysonPaul C. Bryson, MD, MBA

Director, Cleveland Clinic Voice Center; Head, Section of Laryngology, Cleveland Clinic, Cleveland, OH; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH