Persistent Hoarseness: Causes, Treatments, and Diagnosis Options - Otolaryngology

More Info

---

Persistent hoarseness, or a prolonged change in voice quality, can be a frustrating and concerning symptom. It is important to understand that hoarseness can arise from a variety of causes, and its persistence warrants a thorough evaluation.

Causes of Persistent Hoarseness
1. Vocal Cord Issues: The most common causes of hoarseness are related to the vocal cords themselves. This can include vocal cord nodules, polyps, or cysts, which can develop due to overuse or misuse of the voice. Inflammation of the vocal cords, known as laryngitis, can also lead to hoarseness.

2. Neurological Conditions: Conditions that affect the nerves supplying the vocal cords can lead to hoarseness. For example, vocal cord paralysis can occur due to damage to the recurrent laryngeal nerve, which can happen after surgery, trauma, or due to certain diseases.

3. Gastroesophageal Reflux Disease (GERD): Acid reflux can irritate the lining of the throat and vocal cords, leading to chronic hoarseness. This is often accompanied by other symptoms such as heartburn or a sour taste in the mouth.

4. Infections: Viral infections, such as those causing the common cold or flu, can lead to temporary hoarseness. However, if hoarseness persists long after other symptoms have resolved, further investigation is warranted.

5. Allergies and Irritants: Allergies can cause post-nasal drip, which may irritate the throat and lead to hoarseness. Exposure to smoke, chemicals, or other irritants can also contribute.

6. Medications: Certain medications, particularly those that affect the central nervous system, such as antipsychotics, can lead to side effects that include hoarseness or changes in voice.


Diagnosis Options
To determine the underlying cause of persistent hoarseness, a comprehensive evaluation is necessary. Here are some diagnostic options:
- Laryngoscopy: This is a procedure where a doctor uses a small camera to visualize the vocal cords and larynx. It can help identify structural issues, inflammation, or lesions.

- Voice Assessment: A speech-language pathologist can conduct a voice assessment to evaluate how the voice is being used and whether there are any functional issues.

- Imaging Studies: In some cases, imaging studies such as CT scans or MRIs may be needed to assess the surrounding structures and rule out any masses or abnormalities.

- Allergy Testing: If allergies are suspected, testing may be conducted to identify specific allergens that could be contributing to the hoarseness.


Treatment Options
The treatment for persistent hoarseness will depend on the underlying cause. Here are some common approaches:
- Voice Therapy: If the hoarseness is due to vocal misuse or overuse, working with a speech-language pathologist can help improve vocal technique and reduce strain.

- Medications: If allergies or GERD are contributing factors, appropriate medications such as antihistamines or proton pump inhibitors may be prescribed.

- Surgery: In cases where there are structural issues such as nodules or polyps, surgical intervention may be necessary.

- Lifestyle Modifications: Staying hydrated, avoiding irritants (such as smoking), and practicing good vocal hygiene can also be beneficial.


Conclusion
In your case, given the history of hoarseness following an upper respiratory infection and the potential influence of psychiatric medications, it is essential to follow up with an ENT specialist for a thorough evaluation. They can perform a laryngoscopy to assess the vocal cords and determine if there are any physical abnormalities. Additionally, discussing your symptoms with both your ENT and psychiatrist may help in managing any medication-related side effects. Persistent hoarseness should not be ignored, and a comprehensive approach will help in identifying the cause and guiding appropriate treatment.