Dysphonia: Difference between revisions
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ClaireLewis (talk | contribs) No edit summary |
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==Causes/Differential Diagnosis== | ==Causes/Differential Diagnosis== | ||
===Emergent/urgent causes=== | ===Emergent/urgent causes=== | ||
*[[Tracheal injury]], laryngeal airway | *[[Tracheal injury]], laryngeal airway trauma, [[Strangulation]] | ||
*Posterior [[sternoclavicular dislocation]] | *Posterior [[sternoclavicular dislocation]] | ||
*Iatrogenic | *Iatrogenic injury to recurrent laryngeal nerve: [[vagal nerve stimulator complication]], ENT, thyroid, or thoracic surgery | ||
*[[Foreign body aspiration]] | *[[Foreign body aspiration]] | ||
*[[Caustic ingestion]], [[smoke inhalation injury]], [[blister chemical agents]] | *[[Caustic ingestion]], [[smoke inhalation injury]], [[blister chemical agents]] | ||
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*[[Laryngitis]] | *[[Laryngitis]] | ||
*[[GERD]] | *[[GERD]] | ||
*Post [[intubation]], [[laryngeal mask airway]], or [[supraglottic airway]] | |||
*Voice overuse/misuse | *Voice overuse/misuse | ||
*Vocal cord nodules | *Vocal cord nodules | ||
* | *Voice may sound abnormal to you, but be totally normal for that patient! | ||
==Evaluation== | ==Evaluation== | ||
Latest revision as of 04:13, 11 December 2016
Background
- Hoarseness or other abnormality of phonation
- Can indicate potential airway compromise
Causes/Differential Diagnosis
Emergent/urgent causes
- Tracheal injury, laryngeal airway trauma, Strangulation
- Posterior sternoclavicular dislocation
- Iatrogenic injury to recurrent laryngeal nerve: vagal nerve stimulator complication, ENT, thyroid, or thoracic surgery
- Foreign body aspiration
- Caustic ingestion, smoke inhalation injury, blister chemical agents
- Angioedema
- Hypothyroidism/myxedema of vocal cords
- Neck mass, squamous cell carcinoma, mediastinal adenopathy
- Aortic dissection, nontraumatic thoracic aortic dissection
- Epiglottitis, diphtheria
- Ludwig's angina
- Leishmaniasis
- Botulism
- Myasthenia gravis
- Acute flaccid myelitis
- Scorpion envenomation, Elapidae bites
- Stroke (lateral medullary infarction)
- Parkinson's disease
Non-emergent causes
- Laryngitis
- GERD
- Post intubation, laryngeal mask airway, or supraglottic airway
- Voice overuse/misuse
- Vocal cord nodules
- Voice may sound abnormal to you, but be totally normal for that patient!
Evaluation
- Evaluate airway!
- Testing/studies dependant on suspected underlying cause, based on history/exam
Management
- Secure airway!
- Further management based on underlying cause