Differential Diagnosis of Hoarseness of Voice in the Present Scenario: a Clinicopathological Study

a bd cf e ABSTRACT KEYWORDS : Hoarseness of voice is a common symptom encountered in ENT practice. Present study is based on five hundred and thirty four patients presenting with primary complaint of hoarseness, of all age groups, in the outpatient department of Otolaryngology at the tertiary care centre in five years. A detailed history was taken on a preset proforma and thorough clinical examination including direct laryngoscopy (if indicated) was undertaken which resulted into eight categories of different clinical diagnosis. Carcinoma of larynx with 30.7% comprised the largest group followed by vocal cord paralysis by 26.9%. The outcome of this study is that although the most common cause of hoarseness is carcinoma of larynx which showed a significant correlation with smoking, tubercular laryngitis is still common in India in spite of the modern medicines. a b c1 d e f IndiannJ. incidence of various etiologies and clinicopathological aspect of hoarseness. This study was conducted in the department of Otolaryngology & Head and Neck Surgery at tertiary care center over a period of five years (2011-15). Five hundred & thirty four patients presenting with the primary complaint of hoarseness were selected for the study. After a detailed history-taking and thorough general physical and local examination with detailed indirect laryngoscopy, patient were subjected to direct laryngoscopy examination as and when required. Special attention was given to the history of personal habits such as smoking, alcohol intake and tobacco chewing besides recording each individual's profession, history of allergy and medication of any sort. The patients were divided in four groups based on the levels of vocal usage described by Koufman and Isaacson (1991). MATERIALSAND METHODS Hoarseness of voice is one of the commonest symptoms in otolaryngological practice and is invariably the earliest manifestation of a large variety of conditions directly or indirectly affecting the voice apparatus. Hoarseness of voice is a defect of voice quality. Any condition that alters the regular, repetitive synchronous vibrations of vocal cord in conjunction with the breath stream that activates them may create the sounds that are called hoarseness (Moore, 1976). Hoarseness is a symptom and not a disease per se. According to Jackson & Jackson cancer must always be the first diagnostic possibility to be excluded before a diagnosis of chronic laryngitis is made. Hoarseness persisting for more than three weeks must be investigated and a firm diagnosis should be made. It is however strange …