Differential Diagnosis for Hoarseness of Voice
Single most likely diagnosis
- Chronic laryngitis: This is the most likely diagnosis due to the prolonged duration of hoarseness (6 months), which could be caused by persistent irritation or inflammation of the larynx, often resulting from gastroesophageal reflux disease (GERD), allergies, or vocal abuse.
Other Likely diagnoses
- Vocal cord polyps or nodules: These are common causes of hoarseness, especially in individuals who use their voice frequently, such as singers or teachers. The prolonged strain on the vocal cords can lead to the formation of polyps or nodules, affecting voice quality.
- Thyroid disorders: Conditions like hypothyroidism can cause hoarseness due to the effects of hormonal changes on the vocal cords and the surrounding tissues.
- Postnasal drip: Chronic postnasal drip can irritate the vocal cords, leading to hoarseness, especially if the condition persists over time.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Laryngeal cancer: Although less common, laryngeal cancer is a critical diagnosis not to miss, as early detection significantly improves treatment outcomes. Risk factors include smoking and alcohol use.
- Neurological disorders (e.g., Parkinson's disease, myasthenia gravis): Certain neurological conditions can affect the nerves controlling the vocal cords, leading to hoarseness. These conditions require prompt diagnosis and treatment to manage symptoms and slow disease progression.
Rare diagnoses
- Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation of the cartilages, including those in the larynx, 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: The deposition of amyloid proteins in the larynx can lead to hoarseness, although this is a rare cause.