Differential Diagnosis for 8 weeks of Voice Change
- The following differential diagnosis is organized into categories to guide the thought process and identify the most likely causes of voice change.
Single most likely diagnosis
- Laryngitis: This is the most likely diagnosis for an 8-week duration of voice change, as it is a common condition that can be caused by viral or bacterial infections, and can persist for several weeks if not treated properly. Laryngitis can be acute or chronic, and its symptoms include hoarseness, vocal fatigue, and throat pain.
Other Likely diagnoses
- Vocal cord lesions: Lesions on the vocal cords, such as nodules, polyps, or cysts, can cause voice changes that last for several weeks. These lesions can be caused by voice abuse, acid reflux, or other factors.
- Gastroesophageal reflux disease (GERD): GERD can cause stomach acid to flow up into the throat, irritating the vocal cords and leading to voice changes. This condition is common and can be treated with medications or lifestyle changes.
- Allergies: Allergies can cause postnasal drip, which can lead to throat irritation and voice changes. Seasonal allergies or environmental allergies can cause prolonged voice changes if not properly managed.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Laryngeal cancer: Although rare, laryngeal cancer can cause voice changes that last for several weeks. It is essential to rule out this condition, especially in patients with a history of smoking or other risk factors.
- Thyroid disorders: Certain thyroid disorders, such as a thyroid nodule or thyroid cancer, can cause voice changes due to compression or invasion of the recurrent laryngeal nerve.
- Neurological disorders: Conditions like Parkinson's disease, multiple sclerosis, or amyotrophic lateral sclerosis (ALS) can cause voice changes due to neurological damage.
Rare diagnoses
- Sarcoidosis: This is a rare autoimmune disorder that can cause inflammation in the lungs, skin, and other organs, including the larynx, leading to voice changes.
- Relapsing polychondritis: This is a rare autoimmune disorder that can cause inflammation of the cartilage in the larynx, leading to voice changes and other respiratory symptoms.
- Foreign body aspiration: Although rare in adults, foreign body aspiration can cause voice changes if the object becomes lodged in the larynx or trachea.