Differential Diagnosis for Hoarseness of Voice

Single Most Likely Diagnosis

• Acute Laryngitis: This is the most common cause of hoarseness, often resulting from a viral upper respiratory infection. It leads to inflammation of the larynx, affecting the vocal cords and causing hoarseness.

Other Likely Diagnoses

• Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can irritate the vocal cords, leading to hoarseness. This condition is common and can be exacerbated by diet, obesity, and other factors.
• Vocal Cord Nodules or Polyps: These are growths on the vocal cords that can cause hoarseness due to the abnormal vibration of the affected cords. They are often related to voice misuse or overuse.
• Allergies: Postnasal drip from allergies can irritate the vocal cords, leading to hoarseness. This is a common condition, especially in individuals with a history of allergies.

Do Not Miss Diagnoses

• Laryngeal Cancer: Although less common, laryngeal cancer can present with hoarseness as an early symptom. It is crucial to rule out this diagnosis, especially in smokers or those with a significant smoking history.
• Vocal Cord Paralysis: This can result from nerve damage, often due to surgery, trauma, or a stroke. It's a critical diagnosis to consider because of its implications for breathing and swallowing, in addition to voice changes.

Rare Diagnoses

• Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation of the larynx and trachea, leading to hoarseness among other symptoms.
• Sarcoidosis: A condition that can cause granulomas in various parts of the body, including the larynx, potentially leading to hoarseness.
• Amyloidosis: A group of diseases that can lead to the deposition of abnormal proteins (amyloid) in various tissues, including the larynx, causing hoarseness.

Each of these diagnoses has a different set of implications for treatment and prognosis, making a thorough evaluation essential for anyone presenting with hoarseness of voice.