Management of Hoarseness

Abstract

Hoarseness (dysphonia) affects 3.2 million people in the United States every day 1 and has higher prevalence among teachers, older adults, and others with significant vocal demands. 2,3 Dysphonia is a symptom of upper respiratory infection and other common, benign conditions but can herald serious disease that requires prompt diagnosis and management. Most dysphonic patients are cared for by general practitioners, but a multidisciplinary management approach is often needed when symptoms are nonresponsive to standard therapies. The AAO-HNS guidelines 4 weave evidence with consensus expert opinion to inform dysphonia management throughout the spectrum of care to promote evidence-based decision making about appropriate care for dysphonic patients.

Characteristics of Hoarseness in Hasan Sadikin Hospital Bandung 2015-2019

“…This makes it a more comfortable and accessible option for patients, particularly those who may have concerns or limitations with regard to invasive interventions. Additionally, the real-time visualization provided by fiberoptic laryngoscopy allows healthcare professionals to directly observe any abnormalities, such as lesions, inflammation, or structural changes, which may be contributing to the hoarseness.. 11,13,18,19 Laryngoscopy and videostroboscopy are essential diagnostic procedures that play a crucial role in accurately differentiating and diagnosing the underlying causes of hoarseness. Laryngoscopy allows direct visualization of the vocal cords, enabling healthcare professionals to identify any abnormalities or structural changes that may be contributing to the hoarseness.…”

“…These procedures are particularly recommended when hoarseness persists for more than four weeks or when there is suspicion of an underlying serious condition, as they provide valuable visual information for a comprehensive and accurate differential diagnosis. 10,11,17,18 When hoarseness persists for more than four weeks, it is important to give it special attention as it is unlikely to resolve on its own. In such cases, a thorough diagnosis and appropriate treatment are necessary.…”

“…In the case of malignancy in the vocal cords, treatment using transoral laser resection or primary low-volume radiotherapy is recommended. 11,18,20 Resection using a laser is not yet available at the center of this research study, so in cases of malignancy, a total laryngectomy is performed.…”

“…The large number of surgical interventions in this study suggests a higher level of case difficulty, in which behavior modification interventions and medical interventions are not sufficient to deal with the patient's problem. 11,18,20…”