Diagnosing dysphonia

The American Academy of Otolaryngology–Head and Neck Surgery has noted that dysphonia is common enough and debilitating enough that the Academy has created evidence-based clinical practice guidelines. These guidelines can help improve diagnostic accuracy in patients with dysphonia.¹

These diagnostic guidelines suggest that:

1. The history of every patient with altered voice quality, pitch, loudness, or effort should be reviewed for¹:
   • Recent intubation or surgery, especially procedures involving the neck
   • Radiation treatment to the neck
   • History of tobacco use
2. The physician should visualize the patient’s larynx or refer the patient to an ENT who can visualize it with a laryngoscope.¹
3. Stroboscopy should be considered when symptoms are greater than what could be expected from the laryngoscopy results.¹ Videostroboscopy is essential when both vocal folds appear mobile.²

Vocal fold insufficiency is a common contributing factor in patients who present with dysphonia.²