Case Challenge: Diagnosing and Managing Dysphonia

Gordon H. Sun, MD, MS


June 19, 2018

Treatment of Dysphonia

The AAO-HNSF dysphonia guideline update notes that dysphonia is most commonly due to acute viral laryngitis and therefore treatment with an antibiotic will be ineffective.[1] Acute laryngitis is a self-limited condition and typically improves or resolves within 7-10 days, regardless of whether or not antibiotics are prescribed, so an initial observation period is reasonable.[1] Moreover, both antibiotics and inhaled corticosteroids are considered medication-related risk factors for laryngeal candidiasis.[3,4]

Voice Health

Image from Dreamstime

A 25-year-old professional vocalist presented to his PCP with a 2- to 3-year history of chronic hoarseness. The patient was concerned that his hoarseness was affecting his ability to sing emotively. He denied any respiratory or swallowing difficulties. The patient had no other known medical issues. He admitted to smoking a half-pack of cigarettes daily and drinking alcohol nearly every weekend. He was not taking any medications and had no known drug or environmental allergies. The patient indicated he was waiting for a referral to a speech-language pathologist specializing in voice training. In the meantime, he asked his PCP for strategies to promote his vocal health and minimize long-term damage to his vocal cords.


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