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Videos Highlight Tips in Finding Causes of Hoarseness

Hoarseness is a common complaint that can be hard to treat because the vocal folds appear normal on examination. A Tuesday course will use video and audio presentations to spotlight six causes of hoarseness that are often overlooked.

“Even though we are trained well, there is a gap in our knowledge about what causes hoarseness in some patients. This is true especially when a nasal laryngoscopy looks good, but there is still hoarseness and there is not a good explanation for it,” said Jacob P. Noordzij, MD, a co-instructor for “Common Causes of Hoarseness That Are Commonly Missed.”

The course will be presented from 7:30 am-8:30 am in Dallas Ballroom B at the Omni Dallas Hotel. The co-instructor is Seth M. Cohen, MD, Associate Professor at Duke University. Dr. Noordzij is an Associate Professor at Boston University.

“We hope to teach people to be better listeners, to use their ears to recognize the different types of hoarseness that exist,” Dr. Noordzij said. “We are trying to show them the things they had not considered before. A lot of these are neurological conditions, but also functional disorders where there is no disease per se.”

The six causes that will be reviewed:

  • Muscle tension dysphonia, which is a functional disorder whose cause is unclear. “It is more common than a lot of people appreciate, and under-diagnosed, whereas reflux-related hoarseness is probably over-diagnosed. What is tricky about it is that you can’t treat it unless you work with a good speech therapist,” Dr. Noordzij said.
  • Spasmodic dysphonia, which is neurologic tremor. “It is pretty rare, so an average ear, nose, and throat doctor may run across it once or twice a year, not enough to get good at knowing what it sounds like. Videos highlight what about the voice is different so attendees can take away some helpful tips,” he said.
  • Amyotrophic lateral sclerosis (ALS), which is difficult to diagnose. “A lot of patients with ALS in the early stages present with voice changes and swallowing problems. It is not unusual for an ear, nose, and throat doctor to be one of the first doctors to see a patient with ALS, and even make the diagnosis,” Dr. Noordzij said.
  • Vocal cord atrophy, which is more common in aging patients. “Early on, atrophy can be subtle—not to the patient, who notices it and gets frustrated—so the doctor will not recognize it. If a doctor has a heightened awareness, they might consider atrophy,” he said.
  • Vocal cord tremor, which is a common problem. “It has unique voice characteristics, and it is highlighted in the session with videos that tell the story,” Dr. Noordzij said.
  • Parkinson’s disease, which leads to unique voice characteristics. “There is specific voice therapy designed to help these patients. We want to make the point that you should be on the lookout for it and be knowledgeable that there is a specific therapy—Lee Silverman voice therapy—so you can refer patients to the right therapist,” he said.