ABSTRACT

Hoarseness: when a patient should be referred to an ENT specialist

Hoarseness (dysphonia) is a change in the timbre of voice, which is a non-specific patient-perceived symptom that indicates a disturbance in the vibration of the vocal folds during phonation. Hoarseness is the first and, at the same time, one of the most common and most important symptoms of vocal organ dysfunction. It is attributable to changes in the glottis, including in particular the vocal folds. Pathological changes altering any feature of the vocal folds (e.g. weight, tone) can cause hoarseness. Hoarseness can be due to a wide variety of causes. It mostly occurs in organic diseases of the larynx, however, it can also be caused by disturbed innervation of the larynx or disturbed phonation mechanisms associated with functional dysphonia. The most common cause of hoarseness is chronic laryngitis resulting from recurrent acute laryngitis, particularly allergic types, gastroesophageal reflux, smoking, alcohol abuse, prolonged stay in a polluted or dry, air-conditioned environment. Hoarseness may also be the first symptom of laryngeal cancer. In conclusion, it must not be underestimated, and if hoarseness lasts longer than 3 weeks, the patient should be immediately referred to an ENT specialist.