Published 8 October 2008, doi:10.1136/bmj.a1726
Cite this as: BMJ 2008;337:a1726

Practice

Rational Imaging

Investigating the hoarse voice

Pieter M Pretorius, consultant neuroradiologist1, Chris A Milford, consultant ear, nose, and throat surgeon2

1 Department of Neuroradiology, John Radcliffe Hospital, Oxford Radcliffe NHS Trust, Oxford OX3 9DU, 2 Department of ENT Surgery, John Radcliffe Hospital

Correspondence to: P M Pretorius pieter.pretorius@orh.nhs.uk

This article explores the radiological approaches available to investigate the causes of a hoarse voice

The first 150 words of the full text of this article appear below.


Any patient with unexplained hoarseness persisting for more than 3 weeks should be referred to an ear, nose, and throat surgeon for investigation
Clinical examination including laryngoscopy is required to identify the small minority of patients with hoarseness who require imaging
Depending on the findings at laryngoscopy, imaging is aimed at (a) characterising and staging laryngeal or pharyngeal tumours or (b) identifying a cause for vocal cord paralysis
Computed tomography or magnetic resonance can be used for either indication, but MRI is preferable if pathology is expected in the brain stem, skull base, or suprahyoid neck whereas CT is better for imaging pathology in the infrahyoid neck and mediastinum
In an adult smoker with a recurrent laryngeal nerve palsy a chest radiograph can be used to decide on the most appropriate form of CT scan to be performed


A 74 year old man presented with a . . . [Full text of this article]


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