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Hoarseness

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9 Table 5. Examples of Pertinent Questions in the Assessment of a Patient with Dysphonia* Voice specific questions: • Was the onset of your hoarseness abrupt or slowly progressive? • Does your voice ever return to normal or is the hoarseness constant? • Did your voice change at the time or persist after an upper respiratory tract infection? • Do you have pain or is there effort when talking ? • Does your voice deteriorate or fatigue with use? • What is different about the sound of your voice? • Do you have a difficult time getting loud or projecting ? • Have you noticed changes in your pitch or range? • Do you run out of air when talking ? • Does your voice crack or break? • Were you intubated prior to dysphonia onset? • Did you have brain, spine, neck, or chest surgery prior to dysphonia onset? • Did you recently take inhaled medications, antibiotics, or steroids? • Do you need the voice for your occupation? Do you have significant daily voice use requirements? • Do you smoke (tobacco, vape, or use recreational drugs)? • Does your throat feel dry? • Have you undergone radiation therapy to the head and neck region? • Do you have any neurological or arthritic problems? • Did you have prior trauma (physical, emotional, or psychological) preceding the voice change? Symptoms • Globus pharyngeus (persisting sensation of lump in throat) • Dysphagia • Sore throat • Chronic throat clearing • Cough • Odynophagia (pain with swallowing ) • Nasal drainage • Post-nasal drainage • Acid reflux • Regurgitation • Heartburn • Hemoptysis • Non-anginal chest pain • Waterbrash (sudden appearance of salty liquid in the mouth) • Halitosis ("bad breath") • Weight loss • Night sweats • Fever (>101.5° F • Otalgia (ear pain) • Dyspnea (difficulty breathing )

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