ABSTRACT
Hoarseness is defined as the perceived rough, harsh or breathy quality of voice. Since both benign and malignant lesions can produce hoarseness, timely evaluation is very important because delay in the diagnosis of malignancy can adversely affect the outcome. We wanted to study the treatment and its outcome in patients with hoarseness of various aetiologies, and compare the response to treatment between various groups.METHODSThis was a longitudinal study conducted in the Department of ENT in a tertiary care centre in south India. In patients with hoarseness, history was elicited, clinical examination was done, and perceptual evaluation of voice was made using GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scale. Direct laryngoscopy and biopsy were done whenever suspicious lesions were seen. Early laryngeal cancer was treated with radiotherapy, while advanced cases were treated with chemoradiation. Other cases were treated with medications, Video Laryngeal Surgery (VLS) or voice therapy, according to the diagnosis. Patients were kept under follow up; reassessment was done after six months regarding improvement/ persistence/ deterioration of previous symptoms. Laryngoscopy and perceptual evaluation of voice were repeated, and the data collected was analysed.RESULTSOn treatment, the lesion subsided completely, and hoarseness got relieved in all the cases of laryngitis, trauma, vocal nodule, vocal polyp and cyst, while the lesion subsided partially, and hoarseness improved in vocal cord palsy, papilloma and carcinoma of glottis. The response to treatment was better in benign lesions when compared to malignant lesions (P value < 0.0001) and better in glottic malignancies when compared to malignancies at other nearby sites (P value <0.001).CONCLUSIONSMost of the benign conditions that caused hoarseness subsided and voice became normal with medications, video laryngeal surgery and voice therapy, while hoarseness persisted to some extent after treatment with radiotherapy or chemoradiation in most of the patients with malignancy.