What causes a hoarse voice (dysphonia)?

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Last updated: March 17, 2025View editorial policy

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Differential Diagnosis for Hoarse Voice

  • Single most likely diagnosis
    • Acute Laryngitis: This is the most common cause of hoarse voice, often resulting from a viral upper respiratory infection, overuse of the voice, or exposure to irritants like smoke. It's usually self-limiting and resolves with rest and hydration.
  • Other Likely diagnoses
    • Vocal Cord Nodules or Polyps: These are benign growths on the vocal cords that can cause hoarseness due to voice abuse or overuse. They may require surgical intervention if conservative management fails.
    • Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can irritate the vocal cords, leading to hoarseness. This is more likely in individuals with a history of GERD symptoms.
    • Allergic Laryngitis: Allergies can cause inflammation and irritation of the larynx, resulting in a hoarse voice.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Laryngeal Cancer: Although rare, laryngeal cancer can present with persistent hoarseness. It's crucial to investigate further, especially in smokers or those with a significant smoking history.
    • Thyroiditis: Inflammation of the thyroid gland can affect the recurrent laryngeal nerve, leading to hoarseness. This condition requires prompt medical attention.
    • Neurological Disorders (e.g., Parkinson's Disease, Myasthenia Gravis): Certain neurological conditions can affect the nerves controlling the vocal cords, resulting in hoarseness.
  • Rare diagnoses
    • Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation of the laryngeal cartilages, leading to hoarseness.
    • Sarcoidosis: A condition characterized by the growth of granulomas in various parts of the body, including the larynx, which can cause hoarseness.
    • Amyloidosis: A rare condition where abnormal proteins (amyloid) accumulate in various organs, including the larynx, potentially causing hoarseness.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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