Diagnosing dysphonia

How dysphonia is diagnosed

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

Not an actual patient.

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

Not an actual patient.


  1. Rosen CA, Simpson CB. Glottic insufficiency: Vocal fold paralysis, paresis, and atrophy. In: Operative Techniques in Laryngology. Heidelberg, Germany: Springer-Verlag; 2008.
  2. Schwartz SR, Cohen SM, Dailey SH, et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2009;141(3 suppl 2):S1-S31.