Hoarseness can have a profound impact on the working lives of singers, actors, teachers, pastors and many others and can have a large social impact when patients withdraw from social settings.
Dr Matthew Broadhurst is an Ear, Nose and Throat (ENT) surgeon specialising in laryngeal surgery and voice restoration.
"I see patients for hoarseness or roughness to the voice where it affects their day-to-day activities that are both work-related and social. This can range from hoarseness for as little as two to three weeks to those where it has been present for months to years and are sick of it and want it resolved." he said.
Other concerning features can be difficulty breathing, severe coughing or coughing up blood. Dr Broadhurst advises that patients experiencing hoarseness for longer than three weeks should see their GP for referral to a laryngeal specialist.
"A hoarse voice can indicate acute swelling (laryngitis), vocal fold polyp, vocal fold haemorrhage, nodules, a cyst, papilloma, vocal fold paralysis, dysplasia (pre-cancer changes) or even cancer. The most common hoarse patient I see is for a benign vocal fold lesion: polyp, cyst or nodules. Less commonly is one with cancer."
Diagnosis involves examination using a high-resolution video endoscopy with a 1080p or 4K-resolution camera and is coupled with a stroboscopy that shows a slow motion of the vocal folds and highlights the abnormality. Treatment could include the work of a qualified sub-specialised speech therapist. A decision is made whether the patient undergoes speech therapy or is counselled for surgery or office procedure.
"Such procedures consist of KTP laser or Blue Light laser for various diseases, steroid injection, Botox injection, or fillers to help the vocal folds close normally. Most of what I do is cutting edge or innovations that came from my two years of fellowship training at Harvard Medical School."
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