II. History: Exposure

  1. Surgical history
    1. Intubation risks direct Laryngeal Trauma
    2. Head, neck or chest surgery risks Vagus Nerve or recurrent laryngeal nerve Trauma
  2. Voice Abuse
    1. Vocalist or singer
    2. Public speaking, teaching or telemarketing
    3. Umpire or coach
  3. Tobacco Abuse
    1. Differential Diagnosis: Laryngeal Cancer, Leukoplakia, Reinke edema or Chronic Laryngitis
  4. Alcohol Abuse
    1. Differential Diagnosis: Risk of Laryngeal Cancer or Reflux Laryngitis

IV. History: Timing

  1. Evening Onset: Neuromuscular cause
    1. Myasthenia Gravis
    2. Recurrent Laryngeal Nerve Palsy
  2. Morning Onset
    1. Gastroesophageal Reflux (Reflux Laryngitis)
  3. Constant Hoarseness: Larynx Structural Change
    1. Laryngeal Neoplasm
    2. Laryngeal Trauma
    3. Functional Aphonia
    4. Dysphonia Plicae Ventricularis
  4. Intermittent Hoarseness: Benign or transient cause
    1. Voice Abuse
    2. Postnasal drainage

V. History: Associated symptoms

  1. Pharyngitis, Otalgia, and Dysphagia for more than 2 weeks
    1. Laryngeal Neoplasm
  2. Dysphagia or odynophagia
    1. Laryngeal Cancer
    2. Inflammatory Arthritis
    3. Reflux Esophagitis
  3. Dyspnea
    1. Laryngeal Neoplasm
    2. Bilateral vocal cord palsy
    3. Acute Epiglottitis
  4. Wheezing or Asthma
    1. Allergy
    2. Inhaled Corticosteroid
  5. Laryngeal pain
    1. Contact laryngeal ulcer
    2. Cricoarytenoid joint Arthritis or fixation
    3. Viral Laryngitis
    4. Bacterial Laryngitis
    5. Laryngeal Foreign Body
  6. Throat clearing
    1. Allergic Rhinitis
    2. Inhaled Corticosteroids (esp. Flovent)
    3. Reflux Laryngitis
  7. Aspiration
    1. Tracheoesophageal fistula
    2. Unilateral vocal cord palsy (breathy, raspy voice)
    3. Weight loss
    4. Laryngeal Neoplasm
  8. Cough, Hemoptysis, Chest Pain
    1. Intrathoracic cause
  9. Stridor
    1. Laryngeal Cancer
    2. Laryngeal papillomatosis
    3. Vocal Cord Dysfunction
  10. Fever
    1. Viral Laryngitis
    2. Bacterial Laryngitis or Acute Epiglottitis
  11. Generalized weakness, no weight loss
    1. Neuromuscular Causes

VI. History: Voice Quality

  1. Breathy voice
    1. Inflammatory Arthritis
    2. Functional Dysphonia
    3. Vocal Cord Paralysis
    4. Vocal cord lesion
  2. Strangled or halting voice
    1. Spasmodic Dysphonia
  3. Husky, muffled or nasal voice
    1. Parkinsonism
  4. Harsh, raspy voice or strained voice
    1. Reflux Laryngitis
    2. Vocal cord lesion
    3. Functional Dysphonia
  5. Honking voice
    1. Sarcoidosis
  6. Low-pitched voice
    1. Hypothyroidism
    2. Reflux Laryngitis
    3. Functional Dysphonia
    4. Vocal Cord Paralysis
    5. Vocal cord inflammation or edema (Reinke edema or more generalized, Leukoplakia)
    6. Muscle tension Dysphonia
  7. Soft voice
    1. Vocal Cord Paralysis
    2. Parkinsonism
  8. Vocal Fatigue
    1. Functional Dysphonia
    2. Myasthenia Gravis
    3. Parkinsonism
    4. Vocal Abuse
    5. Age-related vocal atrophy
  9. Other specific voice types
    1. Acromegaly
      1. Thick, deep voice with slowed speech
    2. Multiple Sclerosis
      1. Scanning speech and Dysarthria

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Related Studies

Ontology: Hoarseness (C0019825)

Definition (NCI_CTCAE) A disorder characterized by harsh and raspy voice arising from or spreading to the larynx.
Definition (NCI) Harsh and raspy voice secondary to laryngeal infection, voice overuse, irritants inhalation, vocal cord paralysis, vocal cord polyps, and malignant neoplasms arising from or spreading to the larynx.
Definition (MSH) An unnaturally deep or rough quality of voice.
Concepts Sign or Symptom (T184)
MSH D006685
ICD10 R49.0
SnomedCT 206974000, 50219008, 158311009, 162393004, 139661005, 162391002, 139663008, 139664002
English Hoarseness, Hoarsenesses, HOARSENESS, [D]Hoarseness, Hoarseness symptom NOS, [D]Hoarseness (context-dependent category), Hoarse voice quality, hoarseness (symptom), hoarseness, Hoarseness of Voice, Voice Hoarseness, Hoarseness [Disease/Finding], husky voice, hoarse, hoarse voice, Hoarseness;voice, Hoarseness, Voice, [D]Hoarseness (situation), Hoarseness symptom NOS (finding), Hoarse, Hoarseness - throat symptom, Hoarseness symptom, Voice hoarseness, Croaky voice, Husky voice, Hoarse (finding), Hoarse voice, Hoarseness of voice, hoarseness of voice
French ENROUEMENT, Voix enrouée, Enrouement de la voix, Enrouement
Portuguese ROUQUIDAO, Rouquidão da voz, Voz rouca, Rouquidão
Spanish RONQUERA, Voz ronca, [D]ronquera (categoría dependiente del contexto), síntoma de ronquera, SAI, síntoma de ronquera, SAI (hallazgo), Hoarseness symptom NOS, [D]ronquera, [D]ronquera (situación), carraspera, voz ronca (hallazgo), voz ronca, Ronquera
German HEISERKEIT, Heiserkeit der Stimme, heisere Stimme, Heiserkeit
Dutch heesheid van de stem, hese stem, heesheid, Heesheid
Italian Raucedine della voce, Voce roca, Voce rauca, Raucedine
Swedish Heshet
Japanese サセイ, 嗄声, さ声, しわがれ声
Czech chrapot, Chrapot v hlase, Chraptivý hlas, Chrapot
Finnish Käheys
Polish Chrypka
Hungarian Rekedtség
Norwegian Heshet