II. History: Exposure
- Surgical history
- Intubation risks direct Laryngeal Trauma
- Head, neck or chest surgery risks Vagus Nerve or recurrent laryngeal nerve Trauma
-
Voice Abuse
- Vocalist or singer
- Public speaking, teaching or telemarketing
- Umpire or coach
-
Tobacco Abuse
- Differential Diagnosis: Laryngeal Cancer, Leukoplakia, Reinke edema or Chronic Laryngitis
-
Alcohol Abuse
- Differential Diagnosis: Risk of Laryngeal Cancer or Reflux Laryngitis
III. History: Onset
- Acute (without Trauma or Foreign Body Ingestion)
- Chronic
IV. History: Timing
- Evening Onset: Neuromuscular cause
- Myasthenia Gravis
- Recurrent Laryngeal Nerve Palsy
- Morning Onset
- Constant Hoarseness: Larynx Structural Change
- Intermittent Hoarseness: Benign or transient cause
- Voice Abuse
- Postnasal drainage
V. History: Associated symptoms
- Pharyngitis, Otalgia, and Dysphagia for more than 2 weeks
-
Dysphagia or odynophagia
- Laryngeal Cancer
- Inflammatory Arthritis
- Reflux Esophagitis
-
Dyspnea
- Laryngeal Neoplasm
- Bilateral vocal cord palsy
- Acute Epiglottitis
-
Wheezing or Asthma
- Allergy
- Inhaled Corticosteroid
- Laryngeal pain
- Contact laryngeal ulcer
- Cricoarytenoid joint Arthritis or fixation
- Viral Laryngitis
- Bacterial Laryngitis
- Laryngeal Foreign Body
- Throat clearing
- Aspiration
- Tracheoesophageal fistula
- Unilateral vocal cord palsy (breathy, raspy voice)
- Weight loss
- Laryngeal Neoplasm
-
Cough, Hemoptysis, Chest Pain
- Intrathoracic cause
-
Stridor
- Laryngeal Cancer
- Laryngeal papillomatosis
- Vocal Cord Dysfunction
- Fever
-
Generalized weakness, no weight loss
- Neuromuscular Causes
VI. History: Voice Quality
- Breathy voice
- Inflammatory Arthritis
- Functional Dysphonia
- Vocal Cord Paralysis
- Vocal cord lesion
- Strangled or halting voice
- Husky, muffled or nasal voice
- Harsh, raspy voice or strained voice
- Reflux Laryngitis
- Vocal cord lesion
- Functional Dysphonia
- Honking voice
- Low-pitched voice
- Hypothyroidism
- Reflux Laryngitis
- Functional Dysphonia
- Vocal Cord Paralysis
- Vocal cord inflammation or edema (Reinke edema or more generalized, Leukoplakia)
- Muscle tension Dysphonia
- Soft voice
- Vocal Fatigue
- Functional Dysphonia
- Myasthenia Gravis
- Parkinsonism
- Vocal Abuse
- Age-related vocal atrophy
- Other specific voice types
- Acromegaly
- Thick, deep voice with slowed speech
- Multiple Sclerosis
- Scanning speech and Dysarthria
- Acromegaly