Hoarse voiceBMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c522 (Published 07 April 2010) Cite this as: BMJ 2010;340:c522
- O Judd, specialist registrar in ENT1,
- I B Colvin, general practitioner 2
- 1Department of Otolaryngology, Derbyshire Royal Infirmary, Derby DE1 2QY
- 2Elizabeth Avenue Group Practice, London N1 3BX
- Correspondence to: O Judd
- Accepted 4 December 2009
A 38 year old woman who is a teacher presents with a three week history of hoarse voice after a common cold. It is intermittent, with normal voice in between. She reports a sensation of having phlegm in the throat that constantly needs to be cleared.
What you should cover
Hoarseness has a prevalence of 6% in the general population, rising to 11% for professional voice users (30% of the workforce). Most episodes are benign and resolve with vocal hygiene (see box). Laryngeal cancer is an important, but rare, cause of hoarseness (5/100 000 in males and 1/100 000 in females). Most patients with laryngeal cancer have risk factors, mainly smoking, high alcohol intake, and increasing age (72% of cancers occur over the age of 60). Heavy smoking and drinking are synergistic risk factors, and together increase risk 80-fold.
Vocal hygiene advice for patients
Cigarette smoke, dry atmospheres, dust, fumes
Alcohol, caffeine, decongestant drugs
Throat lozenges—they can dry out your throat
Gargling with aspirin
Fatigue, lack of sleep, and eating late at night
Shouting, whispering, screaming, singing, straining your …
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