April 27, 2022 Hoarseness or dysphonia is a frequent symptom that most of the population has already experienced. When approaching dysphonia, it is necessary to analyze first: In what context it was installed; Its duration. Acute or subacute dysphonia Acute or subacute dysphonia, which lasts for less than 7 days, is the most frequent . Causes The causes of acute and subacute dysphonia are mainly infectious , usually viral. Other associated respiratory symptoms occur, such as sore throat, nasal obstruction and cough, with a self-limited duration. In these cases, general care measures should be implemented, such as vocal rest (not talking) and hydration reinforcement with fluid intake and/or use of aerosols. Prescription of anti-inflammatories, nasal decongestants and fluidifiers of secretions is related with a greater comfort for patients. Allergy crisis are another possible cause of acute or subacute dysphonia. In this case, the same general care measures are also indicated in association with antiallergic medication. High-pitched and intense vocal efforts are another possible etiology for hoarseness. The adoption of general care measures of rest and hydration reinforcement is essential. Need for medical care If the acute onset of dysphonia or hoarseness, in the context of a respiratory infection or allergic crisis, lasts for more than 7 days, if a productive cough, chest pain, fever or respiratory difficulty develops , medical care should be sought, for example by resorting to a emergency service, as it may be necessary to prescribe additional medication and/or carry out complementary exams. When dysphonia after acute vocal effort persists, medical care should be sought in an otorhinolaryngology consultation. Chronic dysphonia Chronic or recurrent dysphonia should motivate an otorhinolaryngology consultation . Causes The most common causes of dysphonia or chronic hoarseness are: Recurrent vocal abuse; Incorrect use of voice; Gastric content reflux; Tobacco. Approach to chronic dysphonia In the otorhinolaryngology consultation carried, the doctor will perform a laryngoscopy ( observation of the larynx ), either by indirect laryngoscopy with a laryngeal mirror or using an endoscope. The purpose of laryngoscopy is to identify the possible presence of: Benign lesions such as vocal cord polyps, nodules, cysts, inflammation and bleeding of the vocal cords; Signs of vocal misuse; Malignant or suspicious lesions. In the management of benign laryngeal lesions : General care measures (vocal rest and hydration reinforcement), speech therapy and control of the causes allow, in most cases, to control complaints; Surgery is reserved for the restoration of anatomical and functional normality in specific situations; In specific cases, the otolaryngologist may recommend a voice consultation. Lesions with signs of malignancy or suspicious of being malignant, identified on laryngoscopy, will require a biopsy for diagnosis. This article was written by the otorhinolaryngology team at Hospital da Luz. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
