Differential Diagnosis for Voice Change and Whispering
- Single most likely diagnosis + Laryngitis: This is the most common cause of voice change and whispering, often resulting from inflammation of the larynx due to viral or bacterial infections, overuse of the voice, or exposure to irritants.
- Other Likely diagnoses + Vocal cord lesions (e.g., polyps, nodules, or cysts): These can cause voice changes, including hoarseness or a whispery voice, due to the mechanical disruption of vocal cord function. + Gastroesophageal reflux disease (GERD): Stomach acid reflux can irritate the larynx, leading to inflammation and voice changes. + Thyroid disorders: Certain thyroid conditions, such as hypothyroidism or a thyroid nodule, can affect the voice.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Laryngeal cancer: Although less common, laryngeal cancer can cause voice changes, including a whispery voice, and is a critical diagnosis not to miss due to its potential for severe outcomes if left untreated. + Epiglottitis: This is a rare but life-threatening condition that can cause severe swelling of the epiglottis, leading to airway obstruction and voice changes.
- Rare diagnoses + Neurological disorders (e.g., Parkinson's disease, multiple sclerosis): Certain neurological conditions can affect the nerves controlling the vocal cords, leading to voice changes. + Psychogenic voice disorder: This is a rare condition where psychological factors contribute to voice changes, including a whispery voice, without any underlying physical cause. + Foreign body aspiration: Although more common in children, aspiration of a foreign body can occur in adults and cause sudden voice changes, including whispering, due to airway obstruction.