1. HOARSENESS OF VOICE

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.

6. 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

7. AETIOLOGY
Causes:
1. Inflammation
 Acute- acute laryngitis usually following
cold, influenze, exanthematous fever,
laryngotracheobronchitis, diphtheria
 Chronic- Specific: TB, Syphilis, scleroma,
fungal infections
Non specific: Chronic laryngitis, atrophic
laryngitis

10. 2. Tumors- Benign: Papilloma,
hemangioma, chondroma, fibroma,
leukoplakia
Malignant: Carcinoma
3. Tumor like masses- Vocal nodule,
Vocal polyp, angiofibroma, amyloid
tumor, contact ulcer, laryngocoele
4. Trauma- Sub mucosal haemorrhage,
laryngeal trauma, foreign bodies,
intubation

11. PAPILLOMA

12. CARCINOMA LARYNX

14. VOCAL POLYP

15. 4. Paralysis- paralysis of recurrent,
superior laryngeal or both nerves
5. Fixation of cords- Arthritis, fixation of
cricoaryetenoid joints
6. Congenital- Laryngeal web, cysts,
laryngocoele
7. Miscellaneous- Dysphonia Plica
Ventricularis, Mixoedema, Gout
8. Functional- Hysterical aphonia

16. LARYNGOCOELE

17. FIXATION OF CORDS

18. LARYNGEAL WEB

19. 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.

20. 2. Indirect Laryngoscopy
Many of the local laryngeal causes
can be diagnosed
3. Examination of neck, chest,
cardiovascular and neurological
systems for laryngeal paralysis

21. INDIRECT LARYNGOSCOPY

23. 4. Lab investigations and Radiological
examination
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

24. Thank you