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2015 ; 112
(19
): 329-37
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Hoarseness-causes and treatments
#MMPMID26043420
Reiter R
; Hoffmann TK
; Pickhard A
; Brosch S
Dtsch Arztebl Int
2015[May]; 112
(19
): 329-37
PMID26043420
show ga
BACKGROUND: Hoarseness (dysphonia) is the reason for about 1% of all
consultations in primary care. It has many causes, ranging from self-limited
laryngitis to malignant tumors of the vocal cords. METHODS: This review is based
on literature retrieved by a selective search in PubMed employing the terms
"hoarseness," "hoarse voice," and "dysphonia," on the relevant guideline of the
American Academy of Otolaryngology -Head and Neck Surgery, and on Cochrane
reviews. RESULTS: Hoarseness can be caused by acute (42.1%) and chronic
laryngitis (9.7%), functional vocal disturbances (30%), and benign (10.7-31%) and
malignant tumors (2.2-3%), as well as by neurogenic disturbances such as vocal
cord paresis (2.8-8%), physiologic aging of the voice (2%), and psychogenic
factors (2-2.2 %). Hoarseness is very rarely a manifestation of internal medical
illness. The treatment of hoarseness has been studied in only a few randomized
controlled trials, all of which were on a small scale. Voice therapy is often
successful in the treatment of functional and organic vocal disturbances (level
1a evidence). Surgery on the vocal cords is indicated to treat tumors and
inadequate vocal cord closure. The only entity causing hoarseness that can be
treated pharmacologically is chronic laryngitis associated with gastro-esophageal
reflux, which responds to treatment of the reflux disorder. The empirical
treatment of hoarseness with antibiotics or corticosteroids is not recommended.
CONCLUSION: Voice therapy, vocal cord surgery, and drug therapy for appropriate
groups of patients with hoarseness are well documented as effective by the
available evidence. In patients with risk factors, especially smokers, hoarseness
should be immediately evaluated by laryngos - copy.