10
Diagnosis
Table 5. Examples of Pertinent Questions in the Assessment
of a Patient with Dysphonia* (cont'd)
Medical history relevant to dysphonia
• Occupation and/or avocation requiring extensive voice use (i.e., teacher, singer)
• Absenteeism from occupation due to dysphonia
• Prior episode(s) of hoarseness
• Relationship of instrumentation (e.g., intubation) to onset of dysphonia
• Relationship of prior neck or chest surgery to onset of dysphonia
• Cognitive impairment (requirement for proxy historian)
• Anxiety, depression, stress
Acute conditions
• Infection of the throat and/or larynx: viral, bacterial, fungal
• Foreign body in larynx, trachea, or esophagus
• Neck or laryngeal trauma
Chronic conditions
• Stroke
• Diabetes
• Parkinson's disease
• Parkinson-plus syndromes (e.g.,
progressive supranuclear palsy)
• Myasthenia gravis
• Multiple sclerosis
• Amyotrophic lateral sclerosis (ALS)
• Essential tremor
• Testosterone deficiency
• Allergic rhinitis
• Chronic rhinitis
• Hypertension (because of certain
medications used for this condition)
• Schizophrenia (because of anti-
psychotics used for mental health
problems)
• Osteoporosis (because of certain
medications used for this condition)
• Asthma (because of use of inhaled
steroids or effect on respiratory
function)
• COPD (because of use of inhaled
steroids or effect on respiratory
function)
• Aneurysm of thoracic aorta (rare cause)
• Laryngeal cancer
• Lung cancer (or metastasis to the lung )
• Thyroid cancer
• Hypothyroidism and other
endocrinopathies
• Vocal fold nodules
• Vocal fold paralysis
• Vocal abuse
• Infective laryngitis
• Chemical laryngitis
• Chronic tobacco use
• Sjögren syndrome
• Alcohol (moderate to heavy use or
abuse)
• Menopause
* Note: ese are example considerations and list is not comprehensive of all pertinent
parameters that may need to be assessed.
