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Dysphonia
From WikEM
Contents
Background
- Hoarseness or other abnormality of phonation
- Can indicate potential airway compromise
Causes/Differential Diagnosis
Emergent/urgent causes
- Tracheal injury, laryngeal airway trauma, Strangulation
- Posterior sternoclavicular dislocation
- Iatrogenic injury to recurrent laryngeal nerve: vagal nerve stimulator complication, ENT, thyroid, or thoracic surgery
- Foreign body aspiration
- Caustic ingestion, smoke inhalation injury, blister chemical agents
- Angioedema
- Hypothyroidism/myxedema of vocal cords
- Neck mass, squamous cell carcinoma, mediastinal adenopathy
- Aortic dissection, nontraumatic thoracic aortic dissection
- Epiglottitis, diphtheria
- Ludwig's angina
- Leishmaniasis
- Botulism
- Myasthenia gravis
- Acute flaccid myelitis
- Scorpion envenomation, Elapidae bites
- Stroke (lateral medullary infarction)
- Parkinson's disease
Non-emergent causes
- Laryngitis
- GERD
- Post intubation, laryngeal mask airway, or supraglottic airway
- Voice overuse/misuse
- Vocal cord nodules
- Voice may sound abnormal to you, but be totally normal for that patient!
Evaluation
- Evaluate airway!
- Testing/studies dependant on suspected underlying cause, based on history/exam
Management
- Secure airway!
- Further management based on underlying cause
Disposition
See Also
External Links
References
Authors
Claire, Anthony Lucero, Daniel Ostermayer, Ross Donaldson, Neil Young
