A Prospective Study to Determine Clinico-Etiological Factors in Hoarseness of Voice.

ABSTRACT

Hoarseness of voice is a very common symptom and needs thorough clinical examination and investigation to determine the underlying cause in every patient. The spectrum of the symptom ranges from minor infections to life threating malignancies. Acute onset causes may be due to secondary viral infections, voice abuse, smoking, trauma to the larynx during thyroid surgeries. Chronic onset may be due to vocal polyp, vocal cord nodules, laryngeal papillomatosis, laryngeal neoplasms, tumours of the vocal cord, functional dysphonia, smoking, gastro-oesophageal reflux, malignancy of thyroid, oesophagus, lungs and neurological involvement by systemic disease like diabetes and TB. We wanted to evaluate the common causes of hoarseness of voice.METHODSThis was a longitudinal study conducted among 100 patients with benign laryngeal lesions attending the Department of ENT-HNS of Rajarajeswari Medical College and Hospital, from 1st December 2015 to 31st November 2016. A detailed history including information on patient’s demographics, clinical presentation, history of trauma, along with history of associated medical and surgical condition was obtained. A thorough systemic examination and laryngeal examination was done.RESULTSMaleFemale ratio was noted to be 1.71. Labourers constituted the single largest group of patients comprising of about 36% of cases. Three fourth of patients were from the rural area. Duration of hoarseness ranged from 1 day (acute onset) to 5 yrs. (mean - 3 months). Septic foci in oral cavity and oropharynx were noted in 42% cases. Apart from change in voice other common symptoms were cough, fever and vocal fatigue. Signs of chronic laryngitis were noted in majority of the cases (22%).CONCLUSIONSThe spectrum of etiological factors for hoarseness varies from minor functional voice disorders to major pathological conditions such as malignancy. Septic foci are important predisposing factor for chronic laryngitis.