Hoarseness Causes

Aka: Hoarseness Causes, Laryngitis Causes

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II. Causes: Primary Intralaryngeal

  1. Acute Laryngitis
    1. Viral Laryngitis (e.g. Upper Respiratory Infection)
    2. Fungal Laryngitis
    3. Bacterial Laryngitis
    4. Acute Epiglottitis
    5. Croup
    6. Bacterial Tracheitis
  2. Chronic Laryngitis
    1. See Medication Causes of Hoarseness
    2. Foreign Body Ingestion
    3. Voice Abuse (most common cause)
    4. Irritants
      1. Gastroesophageal Reflux (Reflux Laryngitis)
      2. Alcohol Abuse
      3. Tobacco smoke exposure (or other environmental irritants)
        1. Irritative Laryngitis with edema of Vocal Cords
    5. Laryngeal growths
      1. Laryngeal Neoplasm (esp. Squamous Cell Carcinoma or premalignant dysplasia)
      2. Laryngeal Polyp (or laryngeal papillomatosis) or Nodules
      3. Reinke Edema (polypoid chorditis, cysts or pseudocysts)
      4. Traumatic Granuloma from intubation

III. Causes: Secondary Intralaryngeal

  1. Intrinsic Laryngeal Muscle Weakness
    1. Hypothyroidism
    2. Myasthenia Gravis
    3. Bulbar palsy (severe Dysphagia also present)
    4. Multiple Sclerosis
    5. Age-related voice atrophy
    6. Parkinsonism
    7. Cerebrovascular Accident
  2. Cricoarytenoid joint Arthritis or fixation
    1. Rheumatoid Arthritis
    2. Gout
    3. Systemic Lupus Erythematosus (SLE)
    4. Acromegaly
    5. Sarcoidosis
    6. Trauma (e.g. Intubation)

IV. Causes: Laryngeal Nerve Damage (left recurrent laryngeal nerve)

  1. Surgical Procedures (Thyroid, neck, chest)
    1. Vagus Nerve or recurrent laryngeal nerve injury
  2. Malignancies
    1. Thyroid Cancer
    2. Esophageal Cancer
    3. Lung Cancer
  3. Neuropathy
    1. Diabetic Neuropathy
    2. Viral Neuropathy

V. Causes: Functional Hoarseness (no organic cause)

  1. Dysphonia Plicae Ventricularis
  2. Spastic Dysphonia (Spasmodic Dysphonia)
  3. Aphonia (complete absence of voice)
  4. Conversion Aphonia

VI. References

  1. Dworkin (2008) Otolaryngol Clin North Am 41(2):419-36 [PubMed]
  2. Feierabend (2009) Am Fam Physician 80(4): 363-70 [PubMed]
  3. House (2017) Am Fam Physician 96(11): 720-8 [PubMed]

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