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- Eric Vance Hastriter, MD
- John M. Olsson, MD
- Brody School of Medicine
East Carolina University
Greenville, NC
Hoarseness is defined best as any change in vocal quality. Phonation occurs during exhalation when the vocal cords shorten and approximate or lengthen and separate through the actions of the thyroarytenoid and cricoarytenoid muscles, respectively. These muscles take their motor supply from the recurrent laryngeal nerve. The incidence of hoarseness reported in the literature varies between 5% and 40% and reflects diverse disorders.
The history can help to narrow the differential diagnosis. Although the voice may sound normal to the examiner, the patient’s subjective view is more significant. Vocal quality (eg, breathy, alteration in pitch) is important, as is the duration of the symptom. Acute changes suggest trauma or inflammation; a chronic change may point to a structural lesion. Because allergy or gastroesophageal reflux may …
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