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PubMed1992

[Herpes zoster of the right cervical region associated with right facial nerve palsy and hoarseness].

A 69-year-old man was suffering from herpes zoster on his 2nd and 3rd right cervical spinal segments and 3rd branch of the trigeminal nerve. He came to our hospital on his 10th illness day and was treated with continuous cervical epidural block, intravenous infusion of acyclovir for five days, and oral paramethasone and Vitamin B12. Oh his 18th illness day, right facial nerve palsy and hoarseness became clear. His cerebrospinal fluid showed no abnormality except cell count 23 x 3 mm-2. No clear paralysis of vocal cords was detected on laryngoscopy. He was also treated with right stellate ganglion block starting on his 21st illness day. His pain and facial nerve palsy recovered completely by his 68th illness day, but hoarseness continued about two months. The hoarseness might be a result of spread of the disease 1) by cerebrospinal fluid, 2) by contact with the 3rd cervical nerve and vagal nerve via accessory nerve, and 3) direct effect on the vocal cords and the muscles controlling them. Herpes zoster on the head and neck region shows various complications and we should follow its course cautiously.

Aged↗
PubMed1990

Hoarseness.

The symptom of hoarseness is one with many causes and several treatments. It is the abnormal production of sound, perceived as raspiness, breathiness, harshness, vocal tension, or lower pitched voice. Whether the patient notices vocal fatigue or says that it's harder to talk with a worsening voice as the day progresses, the underlying cause of the hoarseness must be found. Only then can the hoarseness or the disease leading to it be treated competently to bring the patient and the voice back to health.

Hoarseness↗
PubMed1990

[Acoustic evaluation of postoperative hoarseness in adult patients].

The present study was performed to evaluate postoperative hoarseness quantitatively by means of acoustic wave form analysis. Pitch and amplitude perturbation (PPQ, and APQ), and normalized noise energy (NNE) were measured along with the frequency characteristics in 51 adult patients undergoing elective surgery. The normal values for these acoustic parameters were less than 0.5%, less than 2.0%, and less than -10 dB, respectively. Vowel sound "E" was recorded and evaluated before the induction of anesthesia and on the morning of the day after the surgery. PPQ increased from 0.39% to 1.00% (P less than 0.05), APQ increased from 3.34% to 6.62% (P less than 0.05), and NNE increased from -9.19 dB to -4.74 dB (P less than 0.05). Eighteen percent of the patients showed abnormal values in all parameters preoperatively, but 45% of the patients postoperatively (P less than 0.05). These findings suggest that even the short term intubation resulted in the postoperative hoarseness, and this method is a useful and non-invasive bed-side test to evaluate postoperative hoarseness quantitatively.

Acoustics↗
PubMed1989

Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-h ambulatory pH monitoring.

Gastroesophageal reflux (GER) has been implicated in otolaryngologic problems, particularly chronic hoarseness that cannot be attributed to other causes. To study this relationship, we used 24-h ambulatory intraesophageal or dual pharyngoesophageal pH monitoring in 33 patients with chronic hoarseness and laryngeal lesions suggestive of acid irritation. Twenty-six of the patients (78.8%) had pH evidence of severe GER, being at least three times greater than the upper limit of normal. In contrast to 19 patients with proven esophagitis, this GER was worse in the upright position. Of 15 patients with both pharyngeal and esophageal probes, three had esophagopharyngeal reflux, and two had atypical unexplained pharyngeal decreases in pH to below 4.0. Less than half of the 33 patients had the typical symptoms of GER, and standard esophageal tests usually yielded normal findings. Occult GER, predominantly in the upright position, appears to be common and severe in patients with chronic hoarseness, who have laryngeal lesions suggestive of GER. The causative mechanisms are not clear. The 24-h esophageal pH monitor is useful in screening this potentially treatable problem.

Adult↗
PubMed1983

The quantitative evaluation of hoarseness.

As the degree of judged hoarseness increases, the noise component appears to a greater degree and replaces the harmonic structure in the spectrogram. The relationship between these two components has been quantified as the harmonics to noise (H/N) ratio. The computation is straightforward; 50 consecutive pitch periods of a sustained vowel /a/ are averaged; H is the energy of the average waveform, while N is the mean energy of the differences between the individual periods and the average waveform. Therefore, the H/N ratio could be measured in the clinic with the aid of a small, inexpensive computer. This H/N ratio was successfully applied for evaluating the effectiveness of the treatments for hoarseness. Although the H/N ratio does not aid in making a diagnosis of laryngeal abnormality, it would be an important tool for assessing hoarseness.

Female↗
PubMed1993

[Effects of laryngeal mask airway on circulation and on incidence of postoperative sore throat and hoarseness].

We studied the effects of laryngeal mask airway (LM) insertion on circulation and on the incidence of postoperative sore throat or hoarseness as compared with tracheal intubation in 50 pediatric patients. LM insertion caused less change of heart rate and systolic blood pressure than tracheal intubation. The incidence of postoperative sore throat and hoarseness was less in the patient of LM group. We conclude that LM is useful in pediatric anesthesia when less circulatory changes are desirable or when the postoperative sore throat or hoarseness is to be avoided.

Anesthesia, General↗
PubMed1995

Hoarseness: contemporary diagnosis and management.

"Hoarseness" is the term used by most people to describe a change in normal voice quality. It is a very nonspecific term somewhat similar to a patient's complaint of dizziness when describing symptoms from light-headedness to true vertigo. Hoarseness may imply breathiness, roughness, voice breaks, or unnatural changes in pitch. Laryngologists use the general term "dysphonia" to describe abnormal voice quality with no specific etiology implied. A complaint of hoarseness may represent serious disease and, therefore, should not be ignored, especially if it persists for more than two weeks. Before we proceed with a discussion of abnormal voice, it is imperative to understand normal voice production and the relative anatomy.

Acute Disease↗
PubMed2003

Hoarseness after laryngeal blunt trauma: a differential diagnosis between an injury to the external branch of the superior laryngeal nerve and an arytenoid subluxation. A case report and literature review.

Arytenoid subluxation is a well-known cause of hoarseness due to incomplete glottic closure with intact inferior laryngeal nerves after severe laryngeal trauma. We report the case of a young man presenting after laryngeal blunt trauma with hoarseness, easy fatigue during phonation, marked difficulty with his high-pitch and singing voice and decreased phonation time, but intact function of both inferior laryngeal nerves, intact endolaryngeal mucosa sensibility and normal CT scans of the larynx and the neck. Due to the asymmetric anteromedial position of the right arytenoid with incomplete glottic closure, the primary diagnosis was arytenoid subluxation, and the patient was referred for instantaneous relocation therapy. The stroboscopic and electromyographic diagnosis of a unilateral paresis of the external branch of the right superior laryngeal nerve caused the therapy to be changed. Without repositioning, the patient had a total recovery of voice quality when the paresis receded 2 months later. In conclusion, the unilateral paresis of the external branch of the superior laryngeal nerve after laryngeal blunt trauma is reported here for the first time. Although the clinical findings are familiar sequelae of thyroid surgery, they may be misdiagnosed as arytenoid subluxation after laryngeal blunt trauma. Stroboscopy and electromyography permitted the correct diagnosis.

Adult↗
PubMed1996

Hoarseness as the initial manifestation of systemic lupus erythematosus.

A 51-year-old woman complained of hoarseness of two years duration. The patient's past medical history was significant for autoimmunological hepatitis and arthritis for which she had not received treatment. Laryngoscopy and laryngeal stroboscopy revealed 'bamboo joint-like nodules' on both true vocal folds. These nodules resembled rheumatoid nodules and were suggestive of a collagen disease. Previous reports have documented that the treatment for such conditions related to collagen diseases is surgical resection. However, we initially attempted to treat the laryngeal lesions systemically with prednisolone. The hoarseness and the bamboo-like nodules disappeared six months after the treatment. Furthermore, the liver function test returned to normal and arthritis completely resolved. Based on our patient's response to this treatment, we diagnosed atypical-SLE and a lupus laryngitis. This case suggests that studies of the larynx may be helpful in the early diagnosis of collagan diseases and that such conditions may respond to systemic treatment.

Female↗
PubMed1975

Incidence of chronic hoarseness among school-age children.

A speech and voice screening of a kindergarten through eight grade Hebrew day school indicated that: (1) 38 (23.4%) of the 162 children in the school exhibited chronic hoarseness, (2) the incidence was higher in the primary grades, and (3) more boys than girls exhibited the disorder. Vocal nodules were diagnosed in 77.7& of the children examined by otolaryngologists. The findings of this and other recent studies indicate that a large number of school-age children, particularly those in the primary grades, exhibit chronic hoarseness. Futhermore, many such children may be expected to have vocal nodules.

Child↗
PubMed2003

Vocal fold deposits in autoimmune disease--an unusual cause of hoarseness.

The objective of this study was to evaluate the symptoms and clinical characteristics in patients with autoimmune vocal fold deposits. Fourteen patients underwent videolaryngostroboscopic examination and voice recording. Eleven of the 14 patients underwent rheumatological examination. In all cases, endoscopic examination showed transverse white-yellow band lesions in the middle of the membranous portion of the vocal folds. In most cases, the lesions were bilateral but not exactly opposing each other. The most common voice characteristics were instability and intermittent aphonia. Inflammatory disease was present in 10 patients; five of these had rheumatoid arthritis (RA). No immunological signs common for all patients could be found. The histological examination was consistent with rheumatoid nodules. Vocal fold deposits, occurring most often in patients with RA, is an uncommon cause of hoarseness. Because the patients may have hoarseness as their primary symptom, it is important for otolaryngologists to be familiar with this disorder.

Adolescent↗
PubMed1982

Hoarseness associated with lymphoma of the thyroid gland.

Lymphoma of the thyroid gland is usually seen as a rapidly enlarging goiter in older persons, and is associated frequently with dysphagia, hoarseness, and choking. There is infrequent vocal cord paralysis. Three patients with malignant lymphoma seen in a two-year period were hoarse without vocal cord paralysis. Two of them had biopsy-proven lymphoma from within the subglottic trachea.

Aged↗
PubMed2004

Resolution of hoarseness after endovascular repair of thoracic aortic aneurysm: a case of Ortner's syndrome.

We report the case of a 75-year-old man with a 6-month history of hoarseness due to a left recurrent laryngeal nerve palsy. Investigations revealed a thoracic aortic aneurysm compressing the left recurrent nerve; thus, the diagnosis of Ortner's syndrome, ie, cardiovocal syndrome, could be established. The aortic aneurysm was repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 5 days later, and at the 1-year follow-up visit the hoarseness had resolved completely. This case demonstrates for the first time the reversal of Ortner's syndrome after endoluminal aneurysm repair.

Aged↗
PubMed2000

Hoarse voice resulting from premature ageing in Werner's syndrome.

Werner's syndrome is characterized by clinical signs of premature ageing. A 42-year-old man presented with three-year history of hoarseness. Also noted were skin atrophy of the face and hands, ulcerations around the ankles, and a history of cataracts. A clinical diagnosis of Werner's syndrome was made. Laryngoscopy revealed bowed vocal folds resulting in a spindle-shaped defect with glottal incompetence during phonation. Examination also revealed decreased maximum phonation time and vocal fatigue. At surgery, atrophy of the vocalis muscle was noted. Furthermore, degeneration of muscle fibres was noted in the temporalis muscle. The atrophic changes in the vocal folds that occur with ageing and result in an increased fundamental frequency were seen in this patient. The characteristic hoarseness of Werner's syndrome appears to be the result of premature ageing of the vocal-folds.

Adult↗
PubMed1980

Hoarseness as an initial manifestation of sarcoidosis.

A patient had hoarseness, the cause diagnosed as left recurrent laryngeal nerve palsy derived from enlarged sarcoid mediastinal lymph nodes. His symptoms were alleviated by steroid therapy, which was accompanied by the improvement of mediastinal lymph node swelling noted on chest x-ray film. Hoarseness may be listed as one of the symptoms of sarcoidosis.

Adolescent↗
PubMedDate not supplied

Computer analysis of hoarseness.

The harmonic components in hoarse voice were separated from the noise components by using a small laboratory computer. The ratio of harmonics to noise or S/N ratio, was calculated and compared with the auditory impression for 58 subjects. The calculated results showed a definite correlation to the auditory impression, and it is suggested that this would be a useful method for the quantitative evaluation of hoarseness.

Computers↗
PubMed2005

Intrathoracic aneurysm of the right subclavian artery presenting with hoarseness: a case report.

Intrathoracic segment of the subclavian artery is an unusual location for peripheral arterial aneurysms. They are normally caused by atherosclerosis, medial degeneration, trauma, and infection. We report a case of a patient with right subclavian artery aneurysm presenting with hoarseness. Chest radiograph demonstrated a superior mediastinal mass. Laryngoscopy showed a fixed right vocal cord. By chest computed tomography, magnetic resonance imaging, and angiography, preoperative diagnosis was established as a saccular aneurysm with afferent loop and efferent loop. Patient underwent complete resection of the aneurysm followed by endto-end anastomosis via median sternotomy. Postoperative pathology was consistent with an atherosclerotic aneurysm filled with thrombus. After surgical operation, hoarseness is still continued.

Aged↗
PubMed2000

[Farber disease: a cause of hoarseness of the voice in children].

Farber's disease (disseminated lipogranulomatosis) is an autosomal recessive disease characterized by deposition of glycolipid ceramide in different tissues due to deficiency of lysosomal acid ceramidase. The disease starts to manifest at the age of four months by a hoarse cry or swollen tender joints followed by subcutaneous nodules. This disease is fatal in the first years of life and no treatment is known until now. This study presents four cases of Farber's disease who all presented by hoarseness of voice, polyarthritis and subcutaneous nodules. After clinical examination, the diagnosis was confirmed by fiberoptic flexible nasopharyngolaryngoscopy which showed the presence of vocal folds thickening in all patients and affection of the cricoarytenoid joint in one patient and biopsy from the subcutaneous nodules which showed infiltration of the deep dermis and subcutaneous tissues by fibroblasts and large foamy histiocytes.

Acid Ceramidase↗