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At least 19 recordsLinked to original sources
PubMed1995

Chronic cough and hoarseness in patients with severe gastroesophageal reflux disease. Diagnosis and response to therapy.

Gastroesophageal reflux may be responsible for atypical symptoms such as chronic cough and hoarseness. Our aim was to evaluate and treat patients with severe gastroesophageal reflux and chronic cough or hoarseness with intensive antireflux therapy. Twenty-seven patients with typical heartburn symptoms in addition to significant cough or hoarseness were treated with aggressive antireflux therapy. We recorded the response of each symptom to the antireflux therapy. Two patients were lost to follow-up. Twenty of the 25 (80%) patients showed some improvement in cough or hoarseness, nine (36%) had no atypical symptoms at follow-up. The response of heartburn to therapy was strongly predictive of successful therapy for the atypical symptoms. Cough and hoarseness improved in only two of the five patients with residual heartburn symptoms compared to 18 of 20 patients with no heartburn (P < 0.04). Only patients with no heartburn symptoms at follow-up had complete resolution of atypical symptoms. There were no important differences on ambulatory pH monitoring between partial and complete responders. Improvement in atypical reflux symptoms, such as chronic cough and hoarseness, is common with aggressive antireflux therapy. There are no findings on ambulatory esophageal pH monitoring that uniquely identify patients who are likely to respond to antireflux therapy.

Case-Control Studies↗
PubMed1992

Hoarseness after tracheal intubation.

The reported incidence of hoarseness following short-term tracheal intubation varies widely. It has been reported as being permanent in 3%. This suggests that an enormous problem exists considering the numbers of patients intubated daily in the United Kingdom. A prospective study of 235 adult patients undergoing general anaesthesia in a district general hospital included 167 patients whose tracheas were intubated. Of these 167, 54 (32%) complained of hoarseness postoperatively. All but five returned to normal within 7 days. The others were hoarse for 9, 10, 12, 54 and 99 days. Those who were hoarse for 54 and 99 days had vocal cord granulomata. Regression analyses showed that certain patient and anaesthetic factors had a significant effect on the hoarseness. This study confirms a low incidence of prolonged or permanent hoarseness following short-term tracheal intubation.

Adolescent↗
PubMed1981

Persistent hoarseness after surgical removal of vocal cord lesions.

Surgical intervention to remove vocal cord lesions usually results in normal vocal cord quality postoperatively. However, some patients exhibit persistent hoarseness after surgery, and often they are referred to a speech pathologist for vocal rehabilitation. In this study, factors were identified in the case histories, surgical management, and behavior during voice rest of patients who experienced persistent hoarseness postoperatively. Eight of ten adult subjects were interviewed and their voices were tape-recorded before and after surgery and were determined to be hoarse postoperatively. Cumulative medical history was the only significant factor that related to persistent hoarseness. Medical histories of disease or infection affecting the respiratory tract were among the specific factors that were identified. Results indicate that patients with these medical factors should be counseled about the risk of persistent hoarseness after surgery.

Adult↗
PubMed1989

Evaluation of gastroesophageal reflux as a cause of idiopathic hoarseness.

Eleven patients presenting to an ear, nose, and throat specialist were diagnosed as having idiopathic hoarseness and prospectively evaluated for evidence of gastroesophageal reflux (GER) to determine if an association existed. Testing for GER included voice analysis, EGD, esophageal manometry, Bernstein test, and ambulatory 24-hr pH monitoring. Six of the 11 (55%) hoarse patients studied had GER by pH monitoring (mean score 105 +/- 23), and most reflux episodes were supine and prolonged (20.9 +/- 8.2% supine pH less than 4.0, longest 129 min). All patients with abnormal pH monitoring had endoscopic esophagitis (Barrett's esophagus in two, peptic stricture in one, and erosive esophagitis in three), while none of the patients with normal scores had esophagitis. Symptoms of throat pain or nocturnal heartburn were more common in the GER-positive patients (6 of 6 vs 1 of 5), and clinically helpful in discriminating which hoarse patients had pathologic GER. Treatment with ranitidine 150 mg per os twice a day for 12 weeks improved esophagitis in all patients, but the voice improved in only one of the two patients with completely healed esophagitis. This study suggests that (1) GER is frequently seen in patients with idiopathic hoarseness (55%), (2) hoarse patients with throat pain or nocturnal heartburn are likely to have severe esophagitis and should be evaluated by EGD, and (3) additional antireflux and voice therapy may be necessary to heal esophagitis and improve the voice.

Adult↗
PubMed1981

Hoarseness in children: summer camp study.

Ninety-six children attended an 8-week residential summer camp program and were evaluated for hoarseness using a 4 point integral scale. Eighteen percent were hoarse at the start of the camp season and 35% subsequently developed hoarseness during the camping season. Only 4.1% of the children in the first screening and 12.5% of those in the second screening had a moderate degree of hoarseness, while the majority of the hoarse children were judged as having only a mild degree. We believe that children should not be considered for voice screenings until 8 weeks after the start of the school term.

Adolescent↗
PubMed1984

Harmonics-to-noise ratio and psychophysical measurement of the degree of hoarseness.

The degree of hoarseness can be evaluated by judging the extent to which noise replaces the harmonic structure in the spectrogram . The relationship between these two components was quantified as the harmonics-to-noise (H/N) ratio. Eighty-seven phonatory samples (sustained vowel /a/), ranging from nearly normal to severely hoarse, were analyzed. The H/N ratio, the spectrographic classification, and cycle-to-cycle pitch perturbations (jitter) each showed a significant correlation with the psychophysical measurement of the degree of hoarseness (r = .809, .805, and .712, respectively; p less than .001). The analysis also revealed that the correlations of the psychophysical measurement of the degree of hoarseness with the first two parameters were significantly higher than that with jitter (p less than .05). Moreover, the spectrographic classification is subjective, and its scale is discrete and coarse. Therefore, the H/N ratio seems to be the most applicable in the clinic as a quantitative index of the degree of hoarseness.

Hoarseness↗
PubMed1988

Laryngographic investigation of postoperative hoarseness.

This study investigates postoperative hoarseness by comparing the patient's subjective assessment of change in voice following intubation with objective measures made using the laryngograph. Twenty-five patients admitted for routine surgery were assessed pre- and postoperatively. An Fx histogram was recorded on the laryngograph. A linear analogue self-assessment scale was used to quantify hoarseness subjectively. The objective measure of hoarseness (spread or standard deviation of Fx histogram) correlated well with the patients' subjective assessment of hoarseness. Six patients showed a bi- or trimodal histogram following intubation. This is known to represent asymmetric muscular activity. It is concluded that change in voice following intubation correlates well with the measures of vocal fold trauma. These measures can be recorded as the change in spread, standard deviation of the Fx histogram. The transient postoperative hoarseness following intubation is due to laryngeal damage. This damage has 2 mechanisms; in most cases it is due to direct mucosal trauma but in other cases a deeper muscular damage occurs.

Adolescent↗
PubMedDate not supplied

Rechallenge of patients who developed oral candidiasis or hoarseness with beclomethasone dipropionate.

Of 158 asthmatic patients who were placed on inhaled beclomethasone, 15 (9.5%) developed either hoarseness (8), oral thrush (6), or both (1). When their adverse reactions subsided, seven of these 15 patients were rechallenged with inhaled beclomethasone. These included five cases who developed hoarseness and three who developed Candidiasis. One patient had both. Oral thrush did not recur, but 60% (3/5) of patients with hoarseness had recurrence. We conclude that patients may be restarted on inhaled beclomethasone when clinically indicated; however, because of the high recurrence rate, patients who develop hoarseness should not be re-challenged. Concomitant use of oral prednisone and topical beclomethasone may increase the risk of developing hoarseness or candidiasis.

Administration, Inhalation↗
PubMed1987

Harmonic emergence in formant zone of a sustained [a] as a parameter for evaluating hoarseness.

In order to test the value of the harmonic emergence in formant zone of a sustained (a) as a parameter for evaluating hoarseness, a multifactorial acoustical investigation was performed in 10 normal and 22 dysphonic subjects. The parameters were: a subjective evaluation (7-degree-scale) of the extent of the hoarseness by 3 trained specialists the phonation quotient the 0-6 kHz/6-10 kHz energy ratio, computed on a long--time--average--spectrum from a reading of a phonetically selected text the harmonic emergence in the bandwidth of the two first formants of a sustained (a). The harmonic emergence in the formant zone of a sustained (a) seems to be an interesting and complementary parameter, with respect to the previously investigated 0-6 kHz/6-10 kHz energy ratio, for evaluating hoarseness. Both of these parameters demonstrate highly significant differences between normal and pathological voices. Moreover, they show a high degree of correlation both with the subjective evaluation of the severeness of the hoarseness and with the mean transglottic air flow during phonation. The 0-6 kHz/6-10 kHz energy ratio seems to discriminate better in cases of severe dysphonia, while harmonic emergence seems more suitable in milder hoarseness. Both spectral parameters are suitable for automatic analysis.

Adolescent↗
PubMed1982

Harmonics-to-noise ratio as an index of the degree of hoarseness.

Degree of hoarseness can be evaluated by judging the extent to which noise replaces the harmonic structure in the spectrogram of a sustained vowel. However, this visual method is subjective. The present study was undertaken to develop the harmonics-to-noise (H/N) ratio as an objective and quantitative evaluation of the degree of hoarseness. The computation is conceptually straightforward; 50 consecutive pitch periods of a sustained vowel /a/ are averaged; H is the energy of the averaged waveform, while N is the mean energy of the differences between the individual periods and averaged waveform. Recordings of 42 normal voices and 41 samples with varying degrees of hoarseness were analyzed. Two experts rated the spectrogram of each voice sample, based on the amount of noise relative to that of the harmonic component. The results showed a highly significant agreement (the rank correlation coefficient = 0.849) between H/N calculations and the subjective evaluations of the spectrograms. The H/N ratio also proved useful in quantitatively assessing the results of treatment for hoarseness.

Adult↗
PubMed1984

Harmonic-intensity analysis of normal and hoarse voices.

Objective evaluation of normal and hoarse voices is performed considering the characteristic that hoarse voices show a prominent fundamental frequency intensity compared with harmonics in the voice spectrum. The relative harmonic intensity Hr, obtained from a stable portion of the sustained vowel/a/, is defined as the intensity of the second and higher harmonics expressed as a percentage of the total voice intensity. Ninety-five percent of the normal voices examined have Hr larger than the critical value of 67.2%, whereas 90% of the hoarse voices have Hr smaller than the critical value. The harmonic-intensity analysis thus provides good discrimination between normal and hoarse voices.

Adolescent↗
PubMed1988

[Hoarseness after removing a cervical schwannoma--a case report].

A 54-year-old man complained of asymptomatic lump in the right parotid gland region. The lump was well movable and had no fixation to the adjacent tissue. The lump was surgically extirpated and histological sections of the lump revealed benign schwannoma. In view of postoperative evidence of hoarseness, it was thought the tumor might be arose from the cervical vagal nerve. The hoarseness has been observed for one year after operation without any improvement. A statistic study on the hoarseness after removing the cervical tumor was done by sending out questionnaires to the members of the council of the Japan Surgical Society. Of 270, 180 replies were obtained and 67.2% of the members answered that they did not have any knowledge about the hoarseness after removing the cervical tumor.

Cranial Nerve Diseases↗
PubMed1983

[Hoarseness from the viewpoint of primary care].

Hoarseness is a symptom that is constantly encountered by doctors in primary care. It is the leading symptom in acute laryngitis and is often present as one of the symptoms in, for example, respiratory tract infections, influenza, and bronchitis. For the general practitioner, the infection factor as the cause of hoarseness is so dominant that other possible causes may fail to be taken into consideration. The general practitioner's possibilities for diagnosing the cause of this symptom are largely determined by habit, and by his ability to observe and assess the vocal chords. Examination of the vocal chords is often technically difficult, and patients in whom inspection presents difficulties should be remitted to an ear specialist. Hoarse smokers constitute a special group at risk, and these patients should be remitted for further examinations, if the general practitioner finds it hard to make a complete inspection of the chords. The article also describes an investigation on how hoarseness is handled at a health centre.

Hoarseness↗
PubMed1995

[Hoarseness].

Hoarseness is a cardinal symptom of laryngeal disease. It is a disturbance of the normal voice pitch that can be evaluated acoustically using the 'RBH scale' [R for roughness, B for breathiness, H for hoarseness]. Hoarseness lasting longer than three weeks or recurring must be evaluated by an ENT specialist or a phoniatrist. Causes of hoarseness include functional disorders of the voice, inflammation of the larynx, secondary changes of the vocal folds, polyps, cysts, edema, papillomas, tumors, trauma, or palsies of the vocal cords due to different reasons. Early diagnosis of malignant laryngeal tumors is a prerequisite for preserving voice quality. Functional disorders and unilateral palsies of the vocal folds are treated by logopedists. The therapy of choice for inflammations is relief of symptoms, and surgery is employed for organic lesions.

Diagnosis, Differential↗
PubMed1996

Perturbation and hoarseness: a pilot study of six children's voices.

Fundamental frequency (FO) perturbation has been found to be useful as an acoustic correlate of the perception of dysphonia in adult voices. In a previous investigation, we showed that hoarseness in children's voices is a stable concept composed mainly of three predictors: hyperfunction, breathiness, and roughness. In the present investigation, the relation between FO perturbation and hoarseness as well as its predictors was analyzed in running speech of six children representing different degrees of hoarseness. Two perturbation measures were used: the standard deviation of the distribution of perturbation data and the mean of the absolute value of perturbation. The results revealed no clear relation.

Child↗
PubMed1983

Hoarseness in tuberculosis.

A study has been made of hoarseness in 26 tuberculous patients in Kandy (Sri Lanka). Tuberculous inflammation of the vocal cord or ventricular fold was its cause in 18 of them, in 17 of whom the laryngeal infection was due to direct implantation of tubercle bacilli from lung cavities through cough; in one it was probably haematogenous. Hoarseness in the other eight patients was due to recurrent laryngeal nerve palsy, the nerve being involved in tuberculous lesions, in six instances in the mediastinum and in three instances in the right apical pleura. However caused, hoarseness associated with active inflammatory disease cleared with anti-tuberculous chemotherapy, whereas that associated with fibrosis persisted.

Adolescent↗
PubMed1992

Hoarseness in a child with gastroesophageal reflux.

Hoarseness is not generally appreciated to be a manifestation of pediatric gastroesophageal reflux. We describe a case in which treatment of well-documented gastroesophageal reflux and esophagitis in a young girl with hoarseness and nocturnal cough led to resolution of these symptoms. Possible pathogenetic mechanisms and the difficulty in associating hoarseness with reflux by standard reflux testing are discussed.

Child↗
PubMed1995

Aetiologic factors associated with hoarseness in ten-year-old children.

The parents of 55 10-year-old children answered questionnaires concerning 51 elements of potential relevance to voice function such as vocal habits, speech and language development, medical history, social history, physical environment and family relations. In addition, personality profiles of each child were assessed by its teacher and parents. The results were compared to an expert listening panel's evaluation of hoarseness and vocal-fold status as determined by a visual examination by a phoniatrician. Eight boys were identified as being chronically hoarse. Gender, personality and hours spent per day in large groups were highly significant factors associated with hoarseness. A discriminant analysis based on the significant background variables correctly grouped 86.3% of the children.

Child↗