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Hoarseness

A disorder characterized by harsh and raspy voice.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Hoarseness

If you are hoarse, your voice will sound breathy, raspy, or strained, or will be softer in volume or lower in pitch. Your throat might feel scratchy. Hoarseness is often a symptom of problems in the vocal folds of the larynx.

How does our voice work?

The sound of our voice is produced by vibration of the vocal folds, which are two bands of smooth muscle tissue that are positioned opposite each other in the larynx. The larynx is located between the base of the tongue and the top of the trachea, which is the passageway to the lungs (see figure).

When we're not speaking, the vocal folds are open so that we can breathe. When it's time to speak, however, the brain orchestrates a series of events. The vocal folds snap together while air from the lungs blows past, making them vibrate. The vibrations produce sound waves that travel through the throat, nose, and mouth, which act as resonating cavities to modulate the sound. The quality of our voice—its pitch, volume, and tone—is determined by the size and shape of the vocal folds and the resonating cavities. This is why people's voices sound so different....Read more about Hoarseness
NIH - National Institute on Deafness and Other Communication Disorders

What works? Research summarized

Evidence reviews

The ProSeal Laryngeal Mask Airway is more effective than the LMA-Classic in pediatric anesthesia: a meta-analysis

STUDY OBJECTIVE: To determine, in pediatric patients, whether the ProSeal Laryngeal Mask Airway (PLMA) has advantages over the LMA-Classic (cLMA) in leak pressure, placement difficulty, incidence of adverse events, postoperative blood staining, laryngospasm, bronchospasm, and hoarseness.

Oropharyngeal dysphagia after anterior cervical spine surgery: a review

Study Design Review. Objective Postoperative oropharyngeal dysphagia is one of the most common complications following anterior cervical spine surgery (ACSS). We review and summarize recent literature in order to provide a general overview of clinical signs and symptoms, assessment, incidence and natural history, pathophysiology, risk factors, treatment, prevention, and topics for future research. Methods A search of English literature regarding dysphagia following anterior cervical spine surgery was conducted using PubMed and Google Scholar. The search was focused on articles published since the last review on this topic was published in 2005. Results Patients who develop dysphagia after ACSS show significant alterations in swallowing biomechanics. Patient history, physical examination, X-ray, direct or indirect laryngoscopy, and videoradiographic swallow evaluation are considered the primary modalities for evaluating oropharyngeal dysphagia. There is no universally accepted objective instrument for assessing dysphagia after ACSS, but the most widely used instrument is the Bazaz Dysphagia Score. Because dysphagia is a subjective sensation, patient-reported instruments appear to be more clinically relevant and more effective in identifying dysfunction. The causes of oropharyngeal dysphagia after ACSS are multifactorial, involving neuronal, muscular, and mucosal structures. The condition is usually transient, most often beginning in the immediate postoperative period but sometimes beginning more than 1 month after surgery. The incidence of dysphagia within one week after ACSS varies from 1 to 79% in the literature. This wide variance can be attributed to variations in surgical techniques, extent of surgery, and size of the implant used, as well as variations in definitions and measurements of dysphagia, time intervals of postoperative evaluations, and relatively small sample sizes used in published studies. The factors most commonly associated with an increased risk of oropharyngeal dysphagia after ACSS are: more levels operated, female gender, increased operative time, and older age (usually >60 years). Dysphagic patients can learn compensatory strategies for the safe and effective passage of bolus material. Certain intraoperative and postoperative techniques may decrease the incidence and/or severity of oropharyngeal dysphagia after ACSS. Conclusions Large, prospective, randomized studies are required to confirm the incidence, prevalence, etiology, mechanisms, long-term natural history, and risk factors for the development of dysphagia after ACSS, as well as to identify prevention measures. Also needed is a universal outcome measurement that is specific, reliable and valid, would include global, functional, psychosocial, and physical domains, and would facilitate comparisons among studies. Results of these studies can lead to improvements in surgical techniques and/or perioperative management, and may reduce the incidence of dysphagia after ACSS.

Retropharyngeal hematoma after stellate ganglion block: analysis of 27 patients reported in the literature

The authors concluded that retropharyngeal haematoma after stellate ganglion block necessitates emergency airway management. Since airway obstruction cannot be predicted by initial symptoms, emergency airway management tools should be at hand and the openness of the airway should be continuously evaluated. There were limitations to this review but, overall, the authors’ conclusions appear to reflect the limitations of the evidence presented.

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Summaries for consumers

What are the treatment options for an overactive thyroid?

An overactive thyroid can be treated with medication, surgery or radioactive iodine. The most suitable treatment option will mainly depend on the cause of the disease. If the thyroid gland makes too many hormones and releases them into the bloodstream, it can lead to things like weight loss, nervous restlessness and a rapid heartbeat. An overactive thyroid (hyperthyroidism) can have various underlying causes. The most common of these is called Graves’ disease. It also often develops if cells in the thyroid gland start making too many hormones "autonomously" – in other words, without being instructed to by the pituitary gland, which is normally the case. These autonomous cells are either found in nodules or spread throughout the whole gland. Mild hyperthyroidism may get better on its own, without treatment. In most cases, though, the symptoms get worse without treatment. Taking medication is sometimes enough to keep the symptoms under control. But they usually only go away completely in the long term if treated with surgery or radioactive iodine (radioiodine therapy).

Surgery versus non‐surgical interventions (voice therapy, medical treatment) for the resolution of vocal cord nodules

Vocal cord nodules are benign, callous‐like growths on the vocal cords. Symptoms include hoarseness, throat discomfort, pain and an unstable voice when speaking or singing. They can be caused by 'voice abuse' (prolonged shouting or singing above the individual's own range) but may also be caused by infection, allergy or acid reflux.

Fluticasone versus beclomethasone or budesonide for chronic asthma in adults and children

This review compares the effectiveness of three inhaled steroids. Fluticasone (FP) was compared with either beclomethasone (BDP) or budesonide (BUD) for treating people with chronic asthma. When FP was given to children or adults at approximately half the daily dose of either BDP or BUD, it appeared to be at least as effective as the other two drugs in improving airway opening. There was not enough information available to draw conclusions concerning the effect of these drugs on symptoms, or the risk of an acute asthma exacerbation. When given at the same dose as BDP or BUD, FP treated participants had slightly better lung function. However, at the same dose FP was also associated with increased hoarseness, although it did not lead to increased incidences of other side‐effects associated with steroids such as oral thrush or sore throat.

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More about Hoarseness

Photo of an adult woman

Also called: Voice hoarseness

See Also: Laryngitis, Sore Throat

Other terms to know:
Larynx (Voice Box), Voice, Voice Problems

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